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马来西亚沙巴州与潜伏性结核感染预防性治疗不完整相关的因素。

Factors associated with incomplete latent tuberculosis infection preventive treatment in Sabah, Malaysia.

作者信息

Mohamed Ahmad Firdaus, Shafei Mohd Nazri, Wan Mohammad Wan Mohd Zahiruddin, Teo Roddy, Min Hui Amabel Seow

机构信息

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.

Disease Control Division (TB and Leprosy Sector), Sabah State Health Department, Kota Kinabalu, Sabah, Malaysia.

出版信息

PeerJ. 2025 Jul 29;13:e19736. doi: 10.7717/peerj.19736. eCollection 2025.

Abstract

BACKGROUND

Latent tuberculosis infection (LTBI) is a critical public health issue in Malaysia, particularly in regions like Sabah, where the incidence of tuberculosis (TB) remains high. LTBI can progress to active TB if left untreated, making preventive treatment essential in reducing TB transmission. However, adherence to LTBI preventive treatment remains a significant challenge, with incomplete treatment potentially undermining efforts to control TB. This study aimed to determine the proportion of individuals with LTBI who did not complete preventive treatment and to identify associated factors.

METHODS

A retrospective record review was conducted among individuals with LTBI registered in the Sabah State Health Department's LTBIS 401A registry. Multiple logistic regression analyses were applied to determine the factors associated with incomplete preventive treatment.

RESULTS

A total of 895 individuals with LTBI were included in the study. The proportion of incomplete LTBI preventive treatment was 9.2%. Factors that were significantly associated with the incomplete preventive treatment were non-HCW occupation (adj.OR = 4.21, 95 CI [1.25-14.22]), residents of Tawau Division (adj.OR = 2.00, 95% CI [1.10-3.65]), and individuals with LTBI without contact to TB patients (adj.OR = 2.79, 95% CI [1.42-5.48]).

CONCLUSION

The proportion of incomplete preventive treatment among individuals with LTBI in Sabah was comparatively lower than many previous studies. Targeted interventions should be developed to address the specific needs of the groups with higher odds of having incomplete preventive treatment. It includes tackling the social determinants of health, like improving healthcare system accessibility. A prospective study to evaluate these interventions' effectiveness in improving preventive treatment completion rate is recommended.

摘要

背景

潜伏性结核感染(LTBI)是马来西亚一个关键的公共卫生问题,特别是在沙巴等地区,那里的结核病(TB)发病率仍然很高。如果不进行治疗,LTBI可能会发展为活动性结核病,因此预防性治疗对于减少结核病传播至关重要。然而,坚持LTBI预防性治疗仍然是一项重大挑战,治疗不完整可能会破坏结核病控制工作。本研究旨在确定未完成预防性治疗的LTBI患者比例,并确定相关因素。

方法

对在沙巴州卫生部LTBI S 401A登记处登记的LTBI患者进行回顾性记录审查。应用多重逻辑回归分析来确定与预防性治疗不完整相关的因素。

结果

共有895名LTBI患者纳入研究。LTBI预防性治疗不完整的比例为9.2%。与预防性治疗不完整显著相关的因素是非医护人员职业(调整后比值比=4.21,95%置信区间[1.25-14.22])、斗湖地区居民(调整后比值比=2.00,95%置信区间[1.10-3.65])以及未接触过结核病患者的LTBI患者(调整后比值比=2.79,95%置信区间[1.42-5.48])。

结论

沙巴州LTBI患者中预防性治疗不完整的比例相对低于许多先前的研究。应制定有针对性的干预措施,以满足预防性治疗不完整可能性较高群体的特定需求。这包括解决健康的社会决定因素,如提高医疗系统的可及性。建议进行一项前瞻性研究,以评估这些干预措施在提高预防性治疗完成率方面的有效性。

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