Nuwaha F
Department of Community Health, Mbarara University, Uganda.
East Afr Med J. 1997 Nov;74(11):690-3.
An organised TB treatment programme was started in Uganda in 1989. A cohort analysis of treatment outcome among 1400 patients seen in Mbarara district in 1995 showed a very low compliance rate of 56% and this study attempted to look at operational factors that may be associated with this low compliance rate. The factors that are associated with enhanced completion of treatment include; being smear positive: use of short course chemotherapy; previous TB treatment; if patient returned for repeat smear; if patient did not change unit; and if patient did not change district. Gender and age were not associated with compliance. On unconditional logistic regression, previous TB treatment and being smear positive were found not to be statistically significant. Change of health unit after intensive phase showed the highest risk, with an adjusted odds ratio of 22.31. Of the significant factors only use of standard chemotherapy and change of health unit after intensive phase can be altered to improve compliance.
1989年，乌干达启动了一项有组织的结核病治疗计划。1995年对姆巴拉拉地区1400名患者的治疗结果进行的队列分析显示，依从率非常低，仅为56%，本研究试图探讨可能与这种低依从率相关的操作因素。与治疗完成率提高相关的因素包括：涂片阳性；使用短程化疗；既往有结核病治疗史；患者是否回来复查涂片；患者是否未更换治疗单位；以及患者是否未更换所在地区。性别和年龄与依从性无关。在无条件逻辑回归分析中，既往有结核病治疗史和涂片阳性在统计学上无显著意义。强化期后更换卫生单位显示风险最高，调整后的优势比为22.31。在这些显著因素中，只有使用标准化疗和强化期后更换卫生单位这两个因素可以改变，以提高依从性。
