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亚马逊州玛瑙斯市国际移民中潜伏性结核病短疗程治疗(3HP)的依从性:不同治疗方式的疗效评估

Adherence to Short-Duration Treatment (3HP) for Latent Tuberculosis among International Migrants in Manaus, Amazonas: Evaluation of the Efficacy of Different Treatment Modalities.

作者信息

Alves Yan Mathias, Berra Thaís Zamboni, Jezus Sonia Vivian de, Araújo Vânia Maria Silva, Pinheiro Jair Dos Santos, Assis Lara Bezerra de Oliveira de, Canelonez Marvis, Sacramento Daniel Souza, Perez Freddy, Maciel Ethel Leonor Noia, Arcêncio Ricardo Alexandre

机构信息

Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Sao Paulo, Brazil.

Brazilian Tuberculosis Research Network (REDE-TB), Rio de Janeiro 21941-904, Rio de Janeiro, Brazil.

出版信息

Microorganisms. 2024 Aug 9;12(8):1629. doi: 10.3390/microorganisms12081629.

Abstract

Migration, a multifaceted phenomenon, has a significant impact on health. Migrants perform similar movement patterns within their country of origin, in transit, and in the country of destination, thus making it difficult to monitor TB treatment throughout the journey. The objective was to compare the effectiveness of different treatment modalities in adherence to the short-term regimen for LTBI (3HP) among international migrants and refugees. This is a quasi-experimental study conducted in Manaus-AM. The study population was made up of international migrants. The certification and monitoring of medication intake employed three strategies: self-administration (SA), directly observed conventional therapy (DOT), and Video Telemonitoring System for Tuberculosis Treatment (VDOT). The VDOT group and SA group exhibited the lowest rate of treatment dropout or interruption at 16.1%, followed by the DOT group at 23.1%. The results suggest that the most effective strategy for ensuring adherence among migrants and refugees was VDOT (OR_adj 0.26; CI 0.7-0.94), suggesting that migrants may be more likely to adhere to and complete their treatment. The results show that relying on different treatment strategies, adapted to the individuals' needs and risk factors, is a viable and effective way of providing person-centered TB care.

摘要

移民是一个多方面的现象,对健康有重大影响。移民在其原籍国、过境途中以及目的地国有着相似的流动模式,因此在整个过程中监测结核病治疗变得困难。目的是比较不同治疗方式在国际移民和难民中对潜伏性结核感染短期治疗方案(3HP)的依从性效果。这是一项在巴西阿马帕州马瑙斯进行的准实验研究。研究人群由国际移民组成。药物摄入的认证和监测采用了三种策略:自我给药(SA)、直接观察常规治疗(DOT)以及结核病治疗视频远程监测系统(VDOT)。VDOT组和SA组的治疗中断或退出率最低,为16.1%,其次是DOT组,为23.1%。结果表明,确保移民和难民依从性的最有效策略是VDOT(校正后的OR为0.26;CI为0.7 - 0.94),这表明移民可能更有可能坚持并完成治疗。结果显示,依靠适应个体需求和风险因素的不同治疗策略,是提供以人为本的结核病护理的可行且有效方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c19c/11356601/dada5961c98e/microorganisms-12-01629-g001.jpg

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