广东省耐多药结核病患者未纳入治疗的影响因素分析

Influencing factors of untreated patients with multidrug-resistant tuberculosis in Guangdong

目的探讨广东省耐多药结核病(MDR-TB)患者未纳入治疗情况及其相关影响因素。方法以2018—2019年广东省9个地级市10家MDR-TB定点医疗机构确诊的MDR-TB患者为研究对象,根据是否接受MDR-TB治疗分为纳入治疗组和未纳入治疗组。采用问卷收集患者个体和地市相关影响因素,采用两水平Logistic回归模型探索MDR-TB患者是否纳入治疗的影响因素。结果530例MDR-TB患者中,有398例纳入治疗(75.1%),132例未纳入治疗(24.91%),患者男女性别比为2.4∶1。两水平Logistic回归结果显示:文化程度为初、高中及以上(OR=4.302、15.858),职业为农业工作者、已退休或从事其他工作者(OR=5.246、16.662、5.244)的MDR-TB患者更易接受治疗;户籍所在地为外省(OR=0.365)的MDR-TB患者不易接受治疗。结论影响广东省MDR-TB患者纳入治疗的因素与患者文化程度、职业和户籍所在地有关,应针对以上高风险人群采取切实可行的防控措施,进一步提高广东省MDR-TB患者纳入治疗率。

Objective To explore the status of untreated patients with multidrug-resistant tuberculosis(MDR-TB)in Guangdong Province and its influencing factors.Methods The MDR-TB patients diagnosed in 10 designated medical institutions in 9 prefecture-level cities in Guangdong Province from 2018 to 2019 were selected,and they were divided into the treatment group and the non-treatment group according to whether they received treatment. The questionnaire was used to collect individual and area-related factors. The two-level Logistic regression model was used to explore the influencing factors of whether MDR-TB patients received treatment.Results Among 530 MDR-TB patients,398 cases(75.1%) were included in the treatment group,and 132 cases(24.91%)were in the non-treatment group,with a male to female ratio of 2.4∶1. The two-level Logistic regression model showed that MDR-TB patients with junior high school,senior high school and above education(OR=4.302,15.858),agricultural workers,retired or other workers(OR=5.246,16.662,5.244)were more likely to receive treatment. MDR-TB patients with registered residence in other provinces(OR=0.365) were not easy to receive treatment.Conclusion The education,occupation,and registered residence location are the influencing factors of untreated patients with MDR-TB in Guangdong Province,which indicated feasible prevention and control measures should be taken for these high-risk groups to improve the inclusion rate of MDR-TB patients in Guangdong Province.