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背景:南非,赫拉比萨结核病规划目的:确定结核病治疗中断的危险因素和趋势方法:资料来源于自1991年开始的控制规划的数据库。描述了目前治疗中断的趋势,用多元回归分析法确定了各种治疗中断的危险因素。对1994—1995间治疗的病人应用Kaplan-Meier的生存曲线法,对治疗中断作了分析。结果:3610例病人中有629例没有完成治疗(17％),其比例从1991/1992年的11％(79例)上升到1996年的22％(201例)。治疗中断的主要危险因素是在1994—1996年和1991—1993年之间进行比较的(其比值为1.9,95％的可信限为1.6-2.4)HIV阳性与阴性相比,(其比值为l.8,95％的可信限为1.4-2.4)督导由乡村诊所与社区卫生人员相比(比值为1.9,95％的可信限为1.4—2.6),男女性的比值为1.3,95％的可信限为1.1—1.6。极少数病人的中断治疗发生在治疗的前2周,治疗中断率维持在每14天增加1％。结论:近来,规划中治疗中断的频率已经上升,最主要的危险因素是诊断年,或许反映了规划执行中病例数增加的影响,在高移民地区确保坚持治疗仍然是以社区为基础的督导化疗规划的一项挑战。
Background: Tuberculosis Program in Herapies, South Africa Purpose: To identify risk factors and trends in the disruption of tuberculosis treatment Methods: Data from the Control Plan database since 1991. Describe the current trends in treatment disruption and use multiple regression analysis to determine the risk factors for various treatment discontinuations. Treatment discontinuation was analyzed using Kaplan-Meier survival curves for the 1994-1995 treated patients. RESULTS: Of the 3610 patients, 629 were untreated (17%), with their proportion rising from 11% (79) in 1991/92 to 22% (201) in 1996. The major risk factors for treatment discontinuation were compared between 1994-1996 and 1991-1993 (with a ratio of 1.9 and a 95% confidence limit of 1.6-2.4) compared with HIV-negative and HIV-negative (with a ratio of with a 95% confidence limit of 1.4-2.4) supervised by rural clinics compared to community health workers (with a 1.9 and 95% confidence limits of 1.4-2.6), with a ratio of men and women of 1.3 and 95 The% confidence limit is 1.1-1.6. The interruption of treatment in very few patients occurred in the first 2 weeks of treatment, and the treatment discontinuation rate was maintained at 1% every 14 days. CONCLUSIONS: Recently, the frequency of planned disruptions has risen. The most important risk factor is the number of years diagnosed, perhaps reflecting an increase in the number of cases being planned. Ensuring adherence to treatment in high-immigrant areas remains a community-based guideline chemotherapy One of the challenges of planning.