1991年至1994年南非农村地区结核病的直接观察治疗
Directly observed therapy for tuberculosis in rural South Africa, 1991 through 1994.
作者信息
Wilkinson D, Davies G R, Connolly C
机构信息
Centre for Epidemiological Research, South African Medical Research Council, Hlabisa, South Africa.
出版信息
Am J Public Health. 1996 Aug;86(8):1094-7. doi: 10.2105/ajph.86.8_pt_1.1094.
OBJECTIVES
This paper describes an audit of a community-based tuberculosis treatment program involving directly observed therapy in South Africa.
METHODS
A program audit of 2473 consecutive tuberculosis patients in Hlabisa Health District, KwaZulu/Natal, South Africa, was conducted between 1991 and 1994.
RESULTS
Monthly admissions increased from 34 per month in 1991 to 66 in 1994. Of 2186 patients managed in Hlabisa, 1903 (87%) received directly observed therapy. Of those receiving directly observed therapy, 1034 (55%) were supervised by volunteers; 743 (72%) of these were supervised by storekeepers. Among those patients managed locally, 1679 (85%) of 1967 surviving patients completed treatment. Completion rates for patients supervised by health workers and non-health workers were the same. Completion fell from a high of 90% in 1992 to 78% in 1994. Mortality increased from 5% in 1991 to 10% in 1994.
CONCLUSIONS
Community-based directly observed therapy that uses an intermittent drug regime and volunteers as supervisors can achieve high treatment completion rates for tuberculosis, even in resource-poor settings.
目的
本文描述了对南非一项基于社区的结核病治疗项目的审计，该项目涉及直接观察治疗。
方法
1991年至1994年期间，对南非夸祖鲁/纳塔尔省赫拉比萨卫生区的2473例连续性结核病患者进行了项目审计。
结果
月入院人数从1991年的每月34例增加到1994年的66例。在赫拉比萨管理的2186例患者中，1903例（87%）接受了直接观察治疗。在接受直接观察治疗的患者中，1034例（55%）由志愿者监督；其中743例（72%）由店主监督。在当地管理的患者中，1967例存活患者中有1679例（85%）完成了治疗。由卫生工作者和非卫生工作者监督的患者的完成率相同。完成率从1992年的90%的高位降至1994年的78%。死亡率从1991年的5%上升到1994年的10%。
结论
基于社区的直接观察治疗，采用间歇用药方案并以志愿者作为监督者，即使在资源匮乏的环境中，也能实现较高的结核病治疗完成率。
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