摘要
Introduction:Treatment and case management of multidrug-resistant tuberculosis(MDR-TB)is a significant challenge in tuberculosis(TB)control and prevention.This pilot study aims to apply and test a new electronic information system in order to help bolster case management of MDR-TB.Methods:The MDR-TB Case Management System(CMS)was developed and piloted in the Yunnan Tuberculosis Clinical Center(TCC)in 2017.Next,5 sites in Yunnan were randomly selected and sampled as pilots in 2018.The real-time regular follow-up rate(RFUR)was calculated for pilot sites.Loss to follow-up(LTFU)rates of MDR-TB treatment cohorts between pilot and non-pilot sites were compared by a chi-square test.LTFU for MDR-TB treatment cohorts was then assessed by univariate and multivariate binary logistic regression.Results:The average regular follow-up rate was 90.7%in TCC and 73.7%in five other pilot sites of Yunnan Province respectively.The average LTFU rate for pilot sites(9.0%)was lower than non-pilot sites(20.6%,P<0.01).The risk of LTFU during MDR-TB treatment reduced 61.7%in CMS pilot cases(adjusted odds ratio:0.38,95%confidence interval:0.23–0.60)compared with non-pilot cases.Conclusions:As a significant supplement to the Tuberculosis Information Management System,the CMS strengthened the collection,analysis,and utilization of strategic information for MDR-TB cases.The system improved case management by embedding it as a tool of the Comprehensive Supportive Care service model.
基金
Funded by the Yunnan Health Training Program for High-Level Talents(Grant No.H-2019027)and Yunnan Provincial High-Level Talent Incubator Program.
