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阿苯达唑治疗中国棘球蚴病患者的依从性和治疗效果评估。

Assessment of compliance and therapeutic efficacy of albendazole treatment in Chinese patients with echinococcosis.

作者信息

Qin Min, Yang Guobing, Yan Jun, Wang Liying, Feng Yu, Wang Dong, Wang Qian, Hou Yanyan, Zhao Jiangshan, Lei Jiaxi, Wang Zhiyi, Jiang Mingzhe, Yu Chenghang, Gavotte Laurent, Frutos Roger

机构信息

National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Centre for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Centre for International Research On Tropical Diseases, Shanghai, China.

Chaoyang District Center for Diseases Prevention and Control of Beijing, Beijing, China.

出版信息

Infect Dis Poverty. 2024 Dec 20;13(1):98. doi: 10.1186/s40249-024-01268-3.

Abstract

BACKGROUND

Echinococcosis is an infectious parasitic disease that is extremely harmful to human health. Albendazole is provided free of charge to patients requiring medication under the central government finance transfer payment scheme for echinococcosis control and prevention in China. Our aim is to monitor the state of patient medication and its therapeutic impact, which will help improve medication compliance and the therapeutic effect.

METHODS

Random cluster sampling was used to select 10 echinococcosis-endemic counties in China, and all albendazole-treated patients in these counties were investigated. The chi-square and Kruskal-Wallis tests were used to compare two or more rates or constituent ratios, and multiple logistic regression analysis was used to identify the influencing factors. The records of patients were reviewed to obtain the initial diagnosis results as well as the most recent follow-up results and time, and efficacy was assessed.

RESULTS

We examined 899 patient files treated with albendazole in 10 endemic counties. Of the 582 evaluable files, 7.9% did not take albendazole, and 69.2% did not take albendazole regularly. Only 22.9% took albendazole regularly. Of the 536 patients who took albendazole, 242 exhibited adverse reactions. Patients who were Tibetan, herdsmen, received no formal education, used emulsion, and exhibited adverse reactions demonstrated poor compliance. A total of 174 patients with cystic echinococcosis received their most recent imaging follow-up results within one year of the investigation date. Among them, 9 patients met the criteria for cure, accounting for 5.2%; 56 patients showed effectiveness, accounting for 32.2%; 105 patients were deemed ineffective, accounting for 59.8%; 5 patients experienced recurrence, accounting for 2.9%.

CONCLUSIONS

Albendazole medication compliance in patients with echinococcosis is not ideal. We must prioritize health education and promotion for Tibetans, herdsmen, and those without formal education. Patients who adhered to their medication regimen achieved higher rates of cure and effectiveness. To improve medication compliance and efficacy, it is particularly important to improve communication and medication guidance for patients receiving emulsions and those with adverse reactions after taking albendazole. Simultaneously strengthen patients' attention to follow-up and re-examination.

摘要

背景

棘球蚴病是一种对人类健康危害极大的传染性寄生虫病。在中国,通过中央财政转移支付防治棘球蚴病项目,为有用药需求的患者免费提供阿苯达唑。我们的目的是监测患者用药状况及其治疗效果,这将有助于提高用药依从性和治疗效果。

方法

采用随机整群抽样方法,在中国选取10个棘球蚴病流行县,对这些县所有接受阿苯达唑治疗的患者进行调查。采用卡方检验和Kruskal-Wallis检验比较两个或多个率或构成比,采用多因素logistic回归分析确定影响因素。查阅患者记录以获取初始诊断结果以及最近的随访结果和时间,并评估疗效。

结果

我们检查了10个流行县899份接受阿苯达唑治疗的患者档案。在582份可评估档案中,7.9%的患者未服用阿苯达唑,69.2%的患者未规律服用阿苯达唑。只有22.9%的患者规律服用阿苯达唑。在536例服用阿苯达唑的患者中,242例出现不良反应。藏族、牧民、未接受过正规教育、使用乳剂以及出现不良反应的患者依从性较差。共有174例囊性棘球蚴病患者在调查日期后1年内获得了最近的影像学随访结果。其中,9例符合治愈标准,占5.2%;56例显效,占32.2%;105例无效,占59.8%;5例复发,占2.9%。

结论

棘球蚴病患者阿苯达唑用药依从性不理想。我们必须优先对藏族、牧民和未接受过正规教育的人群进行健康教育和宣传。坚持用药方案的患者治愈率和显效率更高。为提高用药依从性和疗效,尤其要加强对使用乳剂的患者以及服用阿苯达唑后出现不良反应的患者的沟通和用药指导。同时加强患者对随访和复查的重视。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edf1/11662814/4c42e0704c24/40249_2024_1268_Fig1_HTML.jpg

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