Revankar C R, Naik S S, Ganapati R
Lepr India. 1983 Jan;55(1):117-21.
Available reports both from rural and urban leprosy centres prove beyond any doubt that dapsone is not being consumed regularly by all those who show regular clinic attendance. No reports are available from urban field projects where SET programme is being operated. In this study surprise urine samples of 294 patients of all types (smear positive 53%) mainly on dapsone monotherapy attending (1) leprosy treatment centres in slum clinics situated in the field areas adopted for SET work by Bombay Leprosy Project and (2) general hospital clinics situated predominantly outside the project area were analysed for dapsone/creatinine ratio to judge the extent of drug compliance. 201 out of 294 (68%) were regular and 82 out of 294 (28%) were irregular in consuming DDS as judged by urine examination. 67% of smear positive cases were regular. No difference was found in regularity between patients living within the project area (intensive follow up is done in this group to remind about treatment) and outside project area patients (no reminder followup is done). Similarly no difference was observed in regularity amongst the patients attending slum clinics and general hospital clinics. It could be stated that facilities for treatment offered at general hospitals or dispensaries and encouraging voluntary reporting could be quite fruitful and economical for obtaining better drug compliance in urban areas.
来自农村和城市麻风病防治中心的现有报告确凿无疑地证明,并非所有定期就诊的患者都能按时服用氨苯砜。目前尚无关于正在实施短期强化治疗(SET)项目的城市实地项目的报告。在本研究中,对294例各类患者(涂片阳性率为53%)的随机尿液样本进行了分析,这些患者主要接受氨苯砜单一疗法治疗,他们分别来自:(1)孟买麻风病项目选定开展SET工作的实地地区贫民窟诊所的麻风病治疗中心;(2)主要位于项目区域外的综合医院诊所。通过分析氨苯砜/肌酐比值来判断药物依从性的程度。根据尿液检查判断,294例患者中有201例(68%)服药规律,294例中有82例(28%)服药不规律。涂片阳性病例中有67%服药规律。项目区域内的患者(该组进行强化随访以提醒治疗)和项目区域外的患者(不进行提醒随访)在服药规律方面没有差异。同样,在贫民窟诊所和综合医院诊所就诊的患者之间,服药规律情况也没有差异。可以说,综合医院或药房提供的治疗设施以及鼓励自愿报告,对于在城市地区获得更好的药物依从性可能非常有效且经济。