Plans-Rubió Pedro, Godoy Sofia, Toledo Diana, Domínguez Angela, Caylà Joan, Parron Ignasi, Millet Joan Pau, Godoy Pere
Public Health Agency of Catalonia, 00805 Barcelona, Spain.
CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain.
Trop Med Infect Dis. 2024 Feb 27;9(3):54. doi: 10.3390/tropicalmed9030054.
The aim of this study was to identify factors associated with non-adherence to tuberculosis (TB) preventive treatment among contacts with latent TB infection for new cases of pulmonary TB cases reported in Catalonia in 2019-2021. All contacts aged 18 years or older with a latent TB infection who received a TB preventive treatment were included in the study. The Chi square test and the odds ratios (OR) were used to assess the association between non-adherence to TB preventive treatment and the study variables; a < 0.05 was considered statistically significant. Multiple logistic regression analysis was used to detect the independent factors associated with TB preventive treatment non-adherence; a < 0.05 was considered statistically significant. The percentage of non-adherence to TB preventive treatment found in this study was 23.7%. A multivariable logistic regression analysis determined that the following factors were significantly associated with TB preventive treatment non-adherence among adult contacts: "exposure at school or workplace" (aOR = 3.34), "exposure to an index case without laboratory confirmation of TB" (aOR = 2.07), "immigrant contact" (aOR = 1.81), "male gender" (aOR = 1.75) and "exposure duration < 6 h per week or sporadic" (aOR = 1.60. By contrast, the factor "short-term TB preventive treatment regimen" (aOR = 0.38) was significantly associated with a lower treatment non-adherence. Adherence to TB preventive treatment should be improved among adult contacts of TB pulmonary cases with latent TB infection by recommending short-term treatment regimens and by developing health education activities, with a greater focus on contacts with factors associated with treatment non-adherence.
本研究的目的是确定2019 - 2021年加泰罗尼亚报告的肺结核新病例中，与潜伏性结核感染接触者不坚持结核病预防性治疗相关的因素。所有18岁及以上接受结核病预防性治疗的潜伏性结核感染接触者均纳入本研究。采用卡方检验和比值比（OR）评估不坚持结核病预防性治疗与研究变量之间的关联；a < 0.05被认为具有统计学意义。采用多因素logistic回归分析检测与结核病预防性治疗不坚持相关的独立因素；a < 0.05被认为具有统计学意义。本研究中发现的不坚持结核病预防性治疗的比例为23.7%。多变量logistic回归分析确定，以下因素与成年接触者结核病预防性治疗不坚持显著相关：“在学校或工作场所接触”（调整后比值比[aOR]=3.34）、“接触未通过实验室确诊结核病的索引病例”（aOR = 2.07）、“移民接触者”（aOR = 1.81）、“男性”（aOR = 1.75）和“每周接触时间<6小时或偶尔接触”（aOR = 1.60）。相比之下，“短期结核病预防性治疗方案”这一因素（aOR = 0.38）与较低的治疗不坚持显著相关。对于患有潜伏性结核感染的肺结核病例的成年接触者，应通过推荐短期治疗方案和开展健康教育活动来提高对结核病预防性治疗的依从性，尤其要更加关注那些与治疗不坚持相关因素的接触者。
