志愿者督导管理对于提高暂住人口肺结核病人化疗依从性作用的评价

A COHORT STUDY ON A VOLUNTARY SUPERVISOR PROGRAM TO ENHANCE COMPLIANCE TO ANTITB TREATMENT IN TEMPORARY RESIDENCE POPULATION.

目的：为了补充经济先进地区结核病防治人员相对不足和协助当地结防单位提高治疗覆盖率，一组由志愿者执行的直接监督下短程化疗（ＤＯＴＳ）在深圳市龙岗区沿海三镇进行了实验性研究，旨在对照专业机构评价这组志愿者在提高暂住人口肺结核病人对治疗依从性的作用。方法：９３年７月１日至１２月３１日期间，３７２例暂住人口肺结核病人，由专业机构组管理７４％，志愿者组管理２５％，对两组的服药率提高进行比较。结果：在提高治疗依从性方面，志愿者组优于乡、镇专业机构（Ｐ＝０．０２４），与区专业机构相似（Ｐ＝０．７３０）；成人低年龄组（１５～３４岁）较高年龄组（３５～５５＋岁）管理干涉后明显提高依从性。结论：志愿者能够获得与专业机构相似的治疗依从性，在结防人员短缺时，可由志愿者进行病人管理；成人低年龄组更需接受督导管理（干涉）；

bjective:A group of patients with TB under treatment with DOTS in temporary residence population supervised by voluntary supervisors in a high incidence tuberculosis area in Longgang district,Shenzhen,in order to assist the local TB control grogram with caseholding,and to evaluate the effectiveness of this group of volunteers in enhancing compliance of notified TB patients to treatment.Methods:A cohort study was conducted in 372 cases with TB.Results:The volunteerss group was more compliance to TB treatment than country special group(P=0024),but it was similar to that of District special group(P=0730).The patients aged 34 years and younger after intervention with supervision options were significantly improved the compliance than patients aged 35 years and older.Conclusion:The supervision option provided by the volunteers can improve the compliance like district special group.Lower aged adults group need more supervision with DOT.And illustrate the fact that despite the use of DOT,poor compliance to treatment remains the major barrier to the eradication in China.