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细菌学确诊肺结核患者的接触者对3个月异烟肼-利福平(3HR)结核病预防性治疗(TPT)的接受率和完成率——患者及医护人员的观点

Acceptance and Completion Rates of 3-Month Isoniazid-Rifampicin (3HR) Tuberculosis Preventive Treatment (TPT) Among Contacts of Bacteriologically Confirmed TB Patients-Patients' and Healthcare Workers' Perspectives.

作者信息

Ihesie Austin, Chukwuogo Ogoamaka, Eneogu Rupert, Daniel Olugbenga Kayode, Agbaje Aderonke, Odume Bethrand, Nongo Debby, Ohikhuai Charles, Kadiri-Eneh Nera, Oyelaran Omosalewa, Obianeri Victor, Van Gemert Wayne, Masini Enos Okumu, D'auvergne Cleophas, Ochuko Urhioke, Anyaike Chukwuma, Olarewaju Sunday Olakunle

机构信息

United States Agency for International Development, Central Business District, Abuja 900211, Nigeria.

KNCV Nigeria, Central Business District, Abuja 900211, Nigeria.

出版信息

Trop Med Infect Dis. 2024 Dec 7;9(12):301. doi: 10.3390/tropicalmed9120301.

Abstract

Providing tuberculosis preventive treatment (TPT) to close contacts of persons with TB is a core strategy recommended by WHO for the prevention and control of TB. Nigeria rolled out the 3-month Isoniazid-Rifampicin (3HR) shorter regimen TPT as a pilot for use among eligible adult and child contacts. This study assesses acceptance and completion rates of 3HR TPT among contacts and determines the perspectives of healthcare workers (HCWs) and contacts on acceptance and completion of 3HR TPT in Nigeria. In this cross-sectional descriptive study using mixed methods, records of TPT-eligible clients were retrospectively reviewed, while 18 purposely selected HCWs and 18 contacts on 3HR were interviewed. Of the 30,012 eligible contacts, 12,040 (40.1%) were initiated on TPT. Among these, 8213 (68%) were enrolled on 3HR, and 6972 (84.7%) of them completed treatment. Perceived facilitators include belief in its effectiveness, training among HCWs, and a good understanding of TPT from HCW counseling sessions. Barriers reported were linked to stockouts, misconceptions about side effects, non-disclosures, and disincentive follow-up strategies. The acceptance and completion rate for 3HR TPT was good. Scaling up 3HR TPT will require redesigning policies towards addressing identified barriers and utilizing interventions linked to capabilities, opportunities, and motivations among contacts of TB patients and HCWs.

摘要

向结核病患者的密切接触者提供结核病预防性治疗(TPT)是世界卫生组织推荐的预防和控制结核病的核心策略。尼日利亚推出了为期3个月的异烟肼-利福平(3HR)短程预防治疗方案,作为在符合条件的成人和儿童接触者中使用的试点。本研究评估了接触者中3HR TPT的接受率和完成率,并确定了医护人员和接触者对尼日利亚3HR TPT接受和完成情况的看法。在这项采用混合方法的横断面描述性研究中,回顾性审查了符合TPT条件的患者记录,同时对18名特意挑选的医护人员和18名接受3HR治疗的接触者进行了访谈。在30012名符合条件的接触者中,12040人(40.1%)开始接受TPT治疗。其中,8213人(68%)登记接受3HR治疗,其中6972人(84.7%)完成了治疗。感知到的促进因素包括相信其有效性、医护人员接受培训以及通过医护人员咨询会议对TPT有良好的了解。报告的障碍与药品短缺、对副作用的误解、未披露信息以及缺乏激励的随访策略有关。3HR TPT的接受率和完成率良好。扩大3HR TPT的规模将需要重新设计政策,以解决已确定的障碍,并利用与结核病患者和医护人员接触者的能力、机会和动机相关的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7db/11679968/eb323298c2b5/tropicalmed-09-00301-g001.jpg

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