Pang S C, Harrison R H, Brearley J, Jegathesan V, Clayton A S
Tuberculosis Control Programme, Perth Chest Clinic, Western Australia, Australia.
Int J Tuberc Lung Dis. 1998 Dec;2(12):984-8.
State Tuberculosis Control Programme, Western Australia.
To ascertain baseline information, applicability and efficacy of preventive therapy for tuberculosis (TB) under indirectly supervised treatment in Western Australia.
Retrospective analyses of records of persons with TB infection who were prescribed preventive therapy for the period 1993-1996 inclusive, using simple descriptive statistics.
Preventive therapy was given to 411 persons after screening for TB due to on-arrival migrant surveillance (269), contact tracing (59), tuberculin surveys (59) and other reasons (24). Six-month isoniazid monotherapy (HMT) was prescribed for 403 and multidrug regimens for the remaining eight. Excepting 34 whose compliance was unknown, varying degrees of treatment non-adherence were found in 90 (24%) of the remaining 369 persons given HMT, including 36 (10%) with under five months of total medication. Minor adverse drug effects occurred in 32 (9%) subjects and contributed to the non-adherence in 23 of these. One person has since developed active TB.
Preventive therapy in Western Australia conformed to generally accepted guidelines. Varying degrees of non-adherence to HMT occurred in 24% of persons, but 90% completed adequate therapy under indirect supervision. Non-adherence is significantly related to adverse drug effects.
西澳大利亚州结核病控制项目。
确定西澳大利亚州在间接监督治疗下结核病预防性治疗的基线信息、适用性和疗效。
对1993年至1996年期间接受预防性治疗的结核感染患者记录进行回顾性分析，采用简单描述性统计方法。
因入境移民监测（269例）、接触者追踪（59例）、结核菌素调查（59例）及其他原因（24例）筛查出结核病后，对411人给予预防性治疗。403人采用六个月异烟肼单一疗法（HMT），其余八人采用多药疗法。除34人依从性未知外，在其余369例接受HMT治疗的患者中，90例（24%）存在不同程度的治疗不依从，其中36例（10%）总用药时间不足五个月。32例（9%）受试者出现轻微药物不良反应，其中23例因此导致治疗不依从。此后有一人发展为活动性结核病。
西澳大利亚州的预防性治疗符合普遍接受的指南。24%的患者存在不同程度的HMT治疗不依从，但90%的患者在间接监督下完成了足够疗程的治疗。治疗不依从与药物不良反应显著相关。
