Tu P, Qiu S, Fang H, Smith H L
Institute of Population Research, Peking University, Beijing, China.
Stud Fam Plann. 1997 Jun;28(2):122-31.
This report attempts to present a comprehensive analysis of the acceptability, side effects, and efficacy of Norplant as used in rural areas, based on a field experiment conducted in four counties in Hebei and Shandong Provinces, China. The initial acceptance of Norplant was relatively high but waned after the first year in three of the four counties. Compared with clinical trials, the current study shows a lower prevalence but similar patterns of side effects. The pregnancy rate during the first two years of use is similar to that found in large-scale clinical trials conducted in China, but discontinuation due to other reasons is lower. A three-level logistic regression analysis shows significant variation in the probability of discontinuation due to side effects across counties. It also indicates an increase in the conditional probability of discontinuation with the duration of use. Whereas introducing Norplant and achieving a very low failure rate and high continuation rate in rural areas is feasible under diverse socioeconomic conditions, the results vary significantly across different areas. Particular attention should be paid to the local factors that may affect results.
本报告基于在中国河北省和山东省四个县进行的一项实地试验，试图对诺普兰（Norplant）在农村地区使用的可接受性、副作用和疗效进行全面分析。诺普兰最初的接受度相对较高，但在四个县中的三个县，第一年之后接受度就下降了。与临床试验相比，当前研究显示副作用的发生率较低，但模式相似。使用头两年的怀孕率与在中国进行的大规模临床试验中的情况相似，但因其他原因停药的比例较低。三级逻辑回归分析表明，各县因副作用停药的概率存在显著差异。这也表明停药的条件概率会随着使用时间的延长而增加。虽然在不同的社会经济条件下，在农村地区引入诺普兰并实现极低的失败率和高持续率是可行的，但不同地区的结果差异很大。应特别关注可能影响结果的当地因素。
