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

Evaluation of voluntary supervisor to enhance compliance to anti tuberculosis of temporary residence popualtion

目的为了提高发达地区结核病治疗督导管理率，对一组（ｎ＝３７２）由志愿者执行的ＤＯＴＳ进行了实验性研究，并对照专业机构管理评价其在提高暂住人口病人对治疗依从性的作用。方法３７２例暂住人口结核病人，２５％（ｎ＝９３）的病人由志愿者督导管理；４０％（ｎ＝１４９）由乡卫生院管理；２０％（ｎ＝７４）由镇医院管理和１４％（ｎ＝５２）由区结防所管理。对提高依从性进行各组间Ｍａｎｔｅｌ－Ｈａｅｎｓｚｅｌ分层分析。结果志愿者组优于乡、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。结论志愿者督导管理病人是可行的；成人低年龄组病人更需督导管理（干涉）。

Objective 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 program with case holding,and to evaluate the effectiveness of this group of volunteers in enhance complience 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 comliance than patients aged 35 years and older.Conclusion The supervision option provided by the volureers can improve the comlpliance like district special group.Lower aged adults need more supervision with DOTS.And illustrate the fact that despite the use of DOTS,poor compliance to treatment remains the major barrier to the eradication in China.