Background: Non-adherence to tuberculosis (TB) treatment might prolong disease transmission and also increases the risk of drug resistance. Various studies have been carried out to determine the predictors of non-adhe...Background: Non-adherence to tuberculosis (TB) treatment might prolong disease transmission and also increases the risk of drug resistance. Various studies have been carried out to determine the predictors of non-adherence but intervention-based studies to address treatment adherence are scarce. This study intends to estimate the treatment adherence rates following delivery of patient-centered health education videos in the intervention tuberculosis unit (TU) and to compare the treatment adherence with that in the comparison TU. Methods: An interventional study was conducted in two TUs of Bengaluru urban district among all newly diagnosed TB cases on daily regimen treatment over a period of three months from November 2017 to January 2018. A patient centered health education video was developed and shown by the treatment supporters to all eligible participants consenting to participate in the intervention TU. The video was shown once at the beginning of intensive phase treatment and once in the continuation phase of treatment. A total of 100 patients, 21 from intervention TU and 79 from comparison TU formed the study sample. Patient details were obtained from their treatment cards. Data on missed doses per month per patient were also noted. Data were entered into Microsoft excel worksheet and analyzed using statistical package for social sciences. Data are expressed as frequency and percentages. Chi-square test was applied to compare groups. Results: The majority of the study participants were aged between 25 - 44 years. Equal distribution of cases was seen among males and females. Intervention TU had significantly higher number of pulmonary TB cases. Treatment adherence rates were 90.5% and 84.8% at end of intensive phase and 85% and 71.4% at end of continuation phase in the intervention and comparison TU respectively, and this difference was not statistically significant. Conclusion: Use of mobile video-based health education showed better treatment rates and was found to improve TB treatment adherence.展开更多
Objective:Based on the theory of“Knowledge,Attitude,Practice,”health education was carried out for close contact with tuberculosis(TB)at a university in Beijing,and its impact on the students’awareness of TB was st...Objective:Based on the theory of“Knowledge,Attitude,Practice,”health education was carried out for close contact with tuberculosis(TB)at a university in Beijing,and its impact on the students’awareness of TB was studied.This study could provide a reference for effective health education interventions among close contacts of TB in undergraduates.Methods:102 undergraduates who had close contact with one confirmed case of pulmonary TB in April 2021 at a university were randomly divided into a control group and an intervention group.The intervention group was given the“Knowledge,Attitude,Practice”health education intervention by professionally trained doctors,and were asked to complete a self-designed TB-related questionnaire before and after the intervention.Both groups performed the Tuberculin Skin Test(TST)and chest X-ray(CR)examination.Results:The rate of the TST test was 18.6%,and CR examination showed 0 cases of pulmonary TB.The survey results showed that the TB awareness rate(96.1%,49/51)in the intervention group was significantly higher than that of the control group(51.0%,26/51),and the differences in awareness rate between the two groups were statistically significant(P<0.05).Regarding the attitude/skills toward TB,the prevalence rate of tuberculosis-related attitude/behavior in the intervention group(94.1%,47/51)was significantly higher than that of the control group(60.8%,31/51),and the differences between the two groups were statistically significant(P<0.05).Conclusion:Both self-controlled and parallel-controlled studies showed that the health education intervention of“Knowledge,Attitude,Practice”improved the awareness of TB among close contacts of TB in undergraduates.展开更多
Background: Tuberculosis (TB) still remains a major cause of morbidity and mortality worldwide. In Nigeria, there is little information on antioxidant status of TB patients. In this study, effects of oxidative stress ...Background: Tuberculosis (TB) still remains a major cause of morbidity and mortality worldwide. In Nigeria, there is little information on antioxidant status of TB patients. In this study, effects of oxidative stress markers and vitamins C and E were investigated in pulmonary TB patients at-tending a health care facility in Nigeria. Methods: Sputum specimens were processed for acid-fast bacilli (AFB) while rifampicin resistance was determined by GeneXpert/Rif assay. Patients were screened for HIV after adequate counselling. Assays for hydrogen peroxide (H2O2), malondialde- hyde (MDA), protein carbonyl (PC), myeloperoxidase (MPx), xanthine oxidase (XO), catalase (CAT), superoxide dismutase (SOD), reduced glutathione (GSH), glutathione S-transferase (GST), glu-tathione peroxidase (GPx), α-tocopherol and ascorbic acid were estimated using standard me- thods. Results: Of the 83 recruited subjects, 29 (34.9%) were AFB negative, 30 (36.1%) were AFB positive while 24 (29.0%) were positive for rifampicin resistance. Overall, HIV prevalence was 6.0% while higher rate of 16.7% was found among the rifampicin resistant subjects. Plasma concentrations of H2O2, MDA and PC and also MPx and XO activities were significantly higher among rifampicin resistant subjects compared with AFB positive and AFB negative groups (P < 0.05). Plasma concentration of GSH and the activities of SOD, GST and GPX were significantly reduced in rifampicin resistant subjects compared with the 2 other groups (P < 0.05). The plasma activity of CAT was similar between rifampicin resistant and AFB positive subjects but significantly lower when compared with AFB negative group. Rifampicin resistant subjects had significantly lower concentrations of α-tocopherol and ascorbic acid compared with 2 other groups (P < 0.05). Con- clusion: This study revealed that resistance of TB patients to rifampicin may be due to induction of oxidative stress. Administration of vitamins C and E may be beneficial by reducing the severity of the disease.展开更多
Background: Tuberculosis among non-UK-born Black Africans has been gradually recognized as a public health problem in the UK despite the various interventions implemented. Objectives: To explore the perceptions of non...Background: Tuberculosis among non-UK-born Black Africans has been gradually recognized as a public health problem in the UK despite the various interventions implemented. Objectives: To explore the perceptions of non-UK-born Black Africans about TB health risk;to explore the health seeking behavior of the non-UK-born Black Africans in relation to TB and to explore lay views on TB health education and screening as opportunities for health promotion. Methodology and Study Design: A qualitative methodology was used on a purposively selected sample of 12 non-UK-born Black Africans living in Leeds. Face-to-face interviews were conducted to explore the lay perceptions about TB. Thematic analysis was used to derive important themes in accordance to the study objectives. Ethical approval was provided by Leeds Metropolitan University. Setting: Community setting of non-UK-born Black Africans in Leeds, UK. Results: This population holds mixed views and perceptions about tuberculosis, few facilitators and many barriers existed to current TB prevention efforts. The barriers included: language barriers, barriers related to services and systems, immigration status and stigma despite the benefits involved. The potential for black African communities to readily increase the likelihood of behavior change was found as an important finding for this study. Conclusions: Tuberculosis is a preventable public health problem. Involvement of the non-UK-born black Africans communities in the TB prevention may be beneficial for reducing and tackling TB rates in this population. Such an approach is potentially inexpensive and more readily implementable than other suggested strategies such as changes to immigration policies.展开更多
Health Education has shown itself as essential for the understanding of indi</span><span style="font-family:Verdana;">viduals about psychological and physical changes caused by diseases. The chro...Health Education has shown itself as essential for the understanding of indi</span><span style="font-family:Verdana;">viduals about psychological and physical changes caused by diseases. The chron</span><span style="font-family:Verdana;">ic obstructive pulmonary disease (COPD) is a severe public health problem, and it depends on health education measures for its control. A group of patients with COPD, in pneumatological medical treatment, were investigated to find </span><span style="font-family:Verdana;">information about the disease. An observational, descriptive and analytical study </span><span style="font-family:Verdana;">with analysis and application of a semistructured questionnaire to evaluate the </span><span style="font-family:Verdana;">individuals</span><span style="font-family:Verdana;">’</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> knowledge about the COPD. Collected data were registered and </span><span style="font-family:Verdana;">analyzed using Google Docs. The software used for the calculation of statistica</span><span style="font-family:Verdana;">l </span><span style="font-family:Verdana;">measures was Microsoft Excel<span style="white-space:nowrap;"><sup>®</sup></span>. For the research participants’ characterization</span> <span style="font-family:Verdana;">analysis, the use of grouped data for the frequency distribution of Sturges Rule</span> <span style="font-family:Verdana;">was necessary. This study provided knowledge about which information a group</span><span style="font-family:Verdana;"> of bearers of COPD receives at a college hospital providing treatment. </span><span style="font-family:Verdana;">The interviewed have an average age of 70 years old and most are women with </span><span style="font-family:Verdana;">education level between elementary and high school and diagnose time of 6</span></span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;">8 years. Most of the sample reported knowledge and consciousness about the disease, informed by the doctors, followed by physiotherapists. Although </span><span style="font-family:Verdana;">the role of the Ministry of Health in health education, subjects were better infor</span><span style="font-family:Verdana;">med about the disease by their doctors instead of public campaigns.展开更多
目的:定量评价“肺结核主动筛查+全疗程住院治疗”模式在新疆维吾尔自治区(简称“新疆”)和田地区肺结核患者发现中的实施效果,为新疆肺结核防治工作的稳步推进提供科学依据。方法:收集2012年1月至2021年12月新疆和田地区及未实施全疗...目的:定量评价“肺结核主动筛查+全疗程住院治疗”模式在新疆维吾尔自治区(简称“新疆”)和田地区肺结核患者发现中的实施效果,为新疆肺结核防治工作的稳步推进提供科学依据。方法:收集2012年1月至2021年12月新疆和田地区及未实施全疗程住院治疗策略的新疆其他地州肺结核报告发病数据。利用Joinpoint回归模型分析肺结核报告发病率的时间趋势。以2018年7月作为“肺结核主动筛查+全疗程住院治疗”模式干预时间点,根据是否设置对照地区,分别构建单组中断时间序列(interrupted time series, ITS)模型和设置对照的ITS模型(controlled interrupted time series, CITS)分析政策干预效果。结果:2012—2021年新疆和田地区肺结核报告发病率最高为2018年的465.10/10万(10 278例),最低为2021年的129.40/10万(3241例),总体呈现下降趋势(AAPC=-4.5%,P<0.05);2012—2018年肺结核报告发病率呈现上升趋势(APC=10.8%,P<0.05),2018—2021年肺结核报告发病率呈快速下降趋势(APC=-29.0%,P<0.05)。ITS模型分析显示,和田地区实施“肺结核主动筛查+全疗程住院治疗”模式后1个月(2018年7月),报告发病率增加16.859/10万(P=0.001),新型模式实施后的长期效果为肺结核报告发病率呈下降趋势(β3=-1.098,P<0.001)。CITS模型分析显示,和田地区在新型模式实施后1个月(2018年7月),肺结核报告发病率明显增加,增加量比对照地区高14.751/10万(P<0.001),新型模式实施后长期效果为肺结核报告发病率呈下降趋势,平均每月下降0.815/10万(β5+β7=-0.815,P<0.001),下降速度大于对照地区(β7=-0.931,P<0.001)。结论:新疆和田地区实施“肺结核主动筛查+全疗程住院治疗”模式与肺结核报告发病率之间存在动态因果关系,该模式促使肺结核报告发病率在短暂地上升后呈现下降的长期趋势。实施该模式对控制结核病高负担地区肺结核疫情具有明显优势。展开更多
目的:评估2011—2020年四川省结核病防治经费投入产生的社会效益,为制定新时期中长期发展规划提供参考依据。方法:采用回顾性研究方法,从“结核病管理信息系统”和“传染病监测”系统中收集四川省2011—2020年(“十二五”和“十三五”期...目的:评估2011—2020年四川省结核病防治经费投入产生的社会效益,为制定新时期中长期发展规划提供参考依据。方法:采用回顾性研究方法,从“结核病管理信息系统”和“传染病监测”系统中收集四川省2011—2020年(“十二五”和“十三五”期间)涂阳肺结核患者治疗转归情况和肺结核患者劳动人口比例,结合四川省统计年鉴和全国结核病防治规划终期评估规划自评调查表等获取经费资料和人均国内生产总值(GDP),采用卫生经济学中常用的成本-效果、成本-效用、成本-效益等3种分析方法估算10年间结核病防治经费投入的社会效果、社会效用和社会效益,并对比分析“十二五”和“十三五”期间的估算结果。结果:2011—2020年,四川省共投入结核病防治经费76032.60万元,成功治疗涂阳肺结核患者160167例,避免了696899名健康人受到传染,挽救了1155277个伤残调整寿命年(disability adjusted life year,DALY),为社会节约医疗费用6.05亿元,挽回社会经济损失约370.32亿元。每投入1091.01元即可避免1名健康人被传染,每投入658.13元即可挽回1个DALY,每投入1元即可产生49.50元的社会经济效益。“十三五”期间带来的总社会效益(209.22亿元)较“十二五”期间(167.14亿元)增长了25.18%[(209.22-167.14)/167.14],但政府每投入1元的结核病防治经费产生的社会效益(47.56元)较“十二五”期间(52.17元)减少了4.61元。结论:2011—2020年间各级政府和国际项目对四川省结核病防控工作投入的经费产生了较好的社会效果、效用和效益。建议在保持目前经费投入力度的基础上,各级政府进一步加大投入,尤其对病原学阳性肺结核患者的发现和治疗管理力度,以期产生更高的社会效益。展开更多
目的探讨耐多药和利福平耐药肺结核病(multidrug-resistant and rifampin-resistant pulmonary tuberculosis,MDR/RR-PTB)患者的健康相关生命质量(health related quality of life,HRQOL)并分析其影响因素。方法选取2021年至2024年巴中...目的探讨耐多药和利福平耐药肺结核病(multidrug-resistant and rifampin-resistant pulmonary tuberculosis,MDR/RR-PTB)患者的健康相关生命质量(health related quality of life,HRQOL)并分析其影响因素。方法选取2021年至2024年巴中市《结核病管理信息系统》登记治疗管理的50例MDR/RR-PTB患者为耐药组,选取同期该系统登记治疗管理的对抗结核药物治疗敏感的肺结核患者50例作为对照组,采用慢性肺结核患者生命质量测定量表(quality of life instuments for chronic disease pulmonary tuberculosis,QLICD-PT)评估并比较两组患者的HRQOL,用多重线性回归分析法分析影响MDR/RR-PTB患者HRQOL的因素。结果与对照组比较,MDR/RR-PTB组患者除生理功能得分外,其他各模块差异均有统计学意义(P<0.05)。单因素分析结果显示,不同性别、医保类别、家庭月收入、有无合并症、淋巴细胞计数、白蛋白、C反应蛋白、体质量指数的患者QLICD-PT总分差异有统计学意义(P<0.05)。多重线性回归分析结果显示,医保类别、家庭月收入差异有统计学意义(P<0.05)。结论MDR/RR-PTB患者HRQOL低于对抗结核药物敏感的肺结核患者,患者的医保类别、家庭月收入是MDR/RR-PTB患者HRQOL的可能影响因素。展开更多
文摘Background: Non-adherence to tuberculosis (TB) treatment might prolong disease transmission and also increases the risk of drug resistance. Various studies have been carried out to determine the predictors of non-adherence but intervention-based studies to address treatment adherence are scarce. This study intends to estimate the treatment adherence rates following delivery of patient-centered health education videos in the intervention tuberculosis unit (TU) and to compare the treatment adherence with that in the comparison TU. Methods: An interventional study was conducted in two TUs of Bengaluru urban district among all newly diagnosed TB cases on daily regimen treatment over a period of three months from November 2017 to January 2018. A patient centered health education video was developed and shown by the treatment supporters to all eligible participants consenting to participate in the intervention TU. The video was shown once at the beginning of intensive phase treatment and once in the continuation phase of treatment. A total of 100 patients, 21 from intervention TU and 79 from comparison TU formed the study sample. Patient details were obtained from their treatment cards. Data on missed doses per month per patient were also noted. Data were entered into Microsoft excel worksheet and analyzed using statistical package for social sciences. Data are expressed as frequency and percentages. Chi-square test was applied to compare groups. Results: The majority of the study participants were aged between 25 - 44 years. Equal distribution of cases was seen among males and females. Intervention TU had significantly higher number of pulmonary TB cases. Treatment adherence rates were 90.5% and 84.8% at end of intensive phase and 85% and 71.4% at end of continuation phase in the intervention and comparison TU respectively, and this difference was not statistically significant. Conclusion: Use of mobile video-based health education showed better treatment rates and was found to improve TB treatment adherence.
文摘Objective:Based on the theory of“Knowledge,Attitude,Practice,”health education was carried out for close contact with tuberculosis(TB)at a university in Beijing,and its impact on the students’awareness of TB was studied.This study could provide a reference for effective health education interventions among close contacts of TB in undergraduates.Methods:102 undergraduates who had close contact with one confirmed case of pulmonary TB in April 2021 at a university were randomly divided into a control group and an intervention group.The intervention group was given the“Knowledge,Attitude,Practice”health education intervention by professionally trained doctors,and were asked to complete a self-designed TB-related questionnaire before and after the intervention.Both groups performed the Tuberculin Skin Test(TST)and chest X-ray(CR)examination.Results:The rate of the TST test was 18.6%,and CR examination showed 0 cases of pulmonary TB.The survey results showed that the TB awareness rate(96.1%,49/51)in the intervention group was significantly higher than that of the control group(51.0%,26/51),and the differences in awareness rate between the two groups were statistically significant(P<0.05).Regarding the attitude/skills toward TB,the prevalence rate of tuberculosis-related attitude/behavior in the intervention group(94.1%,47/51)was significantly higher than that of the control group(60.8%,31/51),and the differences between the two groups were statistically significant(P<0.05).Conclusion:Both self-controlled and parallel-controlled studies showed that the health education intervention of“Knowledge,Attitude,Practice”improved the awareness of TB among close contacts of TB in undergraduates.
文摘Background: Tuberculosis (TB) still remains a major cause of morbidity and mortality worldwide. In Nigeria, there is little information on antioxidant status of TB patients. In this study, effects of oxidative stress markers and vitamins C and E were investigated in pulmonary TB patients at-tending a health care facility in Nigeria. Methods: Sputum specimens were processed for acid-fast bacilli (AFB) while rifampicin resistance was determined by GeneXpert/Rif assay. Patients were screened for HIV after adequate counselling. Assays for hydrogen peroxide (H2O2), malondialde- hyde (MDA), protein carbonyl (PC), myeloperoxidase (MPx), xanthine oxidase (XO), catalase (CAT), superoxide dismutase (SOD), reduced glutathione (GSH), glutathione S-transferase (GST), glu-tathione peroxidase (GPx), α-tocopherol and ascorbic acid were estimated using standard me- thods. Results: Of the 83 recruited subjects, 29 (34.9%) were AFB negative, 30 (36.1%) were AFB positive while 24 (29.0%) were positive for rifampicin resistance. Overall, HIV prevalence was 6.0% while higher rate of 16.7% was found among the rifampicin resistant subjects. Plasma concentrations of H2O2, MDA and PC and also MPx and XO activities were significantly higher among rifampicin resistant subjects compared with AFB positive and AFB negative groups (P < 0.05). Plasma concentration of GSH and the activities of SOD, GST and GPX were significantly reduced in rifampicin resistant subjects compared with the 2 other groups (P < 0.05). The plasma activity of CAT was similar between rifampicin resistant and AFB positive subjects but significantly lower when compared with AFB negative group. Rifampicin resistant subjects had significantly lower concentrations of α-tocopherol and ascorbic acid compared with 2 other groups (P < 0.05). Con- clusion: This study revealed that resistance of TB patients to rifampicin may be due to induction of oxidative stress. Administration of vitamins C and E may be beneficial by reducing the severity of the disease.
文摘Background: Tuberculosis among non-UK-born Black Africans has been gradually recognized as a public health problem in the UK despite the various interventions implemented. Objectives: To explore the perceptions of non-UK-born Black Africans about TB health risk;to explore the health seeking behavior of the non-UK-born Black Africans in relation to TB and to explore lay views on TB health education and screening as opportunities for health promotion. Methodology and Study Design: A qualitative methodology was used on a purposively selected sample of 12 non-UK-born Black Africans living in Leeds. Face-to-face interviews were conducted to explore the lay perceptions about TB. Thematic analysis was used to derive important themes in accordance to the study objectives. Ethical approval was provided by Leeds Metropolitan University. Setting: Community setting of non-UK-born Black Africans in Leeds, UK. Results: This population holds mixed views and perceptions about tuberculosis, few facilitators and many barriers existed to current TB prevention efforts. The barriers included: language barriers, barriers related to services and systems, immigration status and stigma despite the benefits involved. The potential for black African communities to readily increase the likelihood of behavior change was found as an important finding for this study. Conclusions: Tuberculosis is a preventable public health problem. Involvement of the non-UK-born black Africans communities in the TB prevention may be beneficial for reducing and tackling TB rates in this population. Such an approach is potentially inexpensive and more readily implementable than other suggested strategies such as changes to immigration policies.
文摘Health Education has shown itself as essential for the understanding of indi</span><span style="font-family:Verdana;">viduals about psychological and physical changes caused by diseases. The chron</span><span style="font-family:Verdana;">ic obstructive pulmonary disease (COPD) is a severe public health problem, and it depends on health education measures for its control. A group of patients with COPD, in pneumatological medical treatment, were investigated to find </span><span style="font-family:Verdana;">information about the disease. An observational, descriptive and analytical study </span><span style="font-family:Verdana;">with analysis and application of a semistructured questionnaire to evaluate the </span><span style="font-family:Verdana;">individuals</span><span style="font-family:Verdana;">’</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> knowledge about the COPD. Collected data were registered and </span><span style="font-family:Verdana;">analyzed using Google Docs. The software used for the calculation of statistica</span><span style="font-family:Verdana;">l </span><span style="font-family:Verdana;">measures was Microsoft Excel<span style="white-space:nowrap;"><sup>®</sup></span>. For the research participants’ characterization</span> <span style="font-family:Verdana;">analysis, the use of grouped data for the frequency distribution of Sturges Rule</span> <span style="font-family:Verdana;">was necessary. This study provided knowledge about which information a group</span><span style="font-family:Verdana;"> of bearers of COPD receives at a college hospital providing treatment. </span><span style="font-family:Verdana;">The interviewed have an average age of 70 years old and most are women with </span><span style="font-family:Verdana;">education level between elementary and high school and diagnose time of 6</span></span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;">8 years. Most of the sample reported knowledge and consciousness about the disease, informed by the doctors, followed by physiotherapists. Although </span><span style="font-family:Verdana;">the role of the Ministry of Health in health education, subjects were better infor</span><span style="font-family:Verdana;">med about the disease by their doctors instead of public campaigns.
文摘目的:定量评价“肺结核主动筛查+全疗程住院治疗”模式在新疆维吾尔自治区(简称“新疆”)和田地区肺结核患者发现中的实施效果,为新疆肺结核防治工作的稳步推进提供科学依据。方法:收集2012年1月至2021年12月新疆和田地区及未实施全疗程住院治疗策略的新疆其他地州肺结核报告发病数据。利用Joinpoint回归模型分析肺结核报告发病率的时间趋势。以2018年7月作为“肺结核主动筛查+全疗程住院治疗”模式干预时间点,根据是否设置对照地区,分别构建单组中断时间序列(interrupted time series, ITS)模型和设置对照的ITS模型(controlled interrupted time series, CITS)分析政策干预效果。结果:2012—2021年新疆和田地区肺结核报告发病率最高为2018年的465.10/10万(10 278例),最低为2021年的129.40/10万(3241例),总体呈现下降趋势(AAPC=-4.5%,P<0.05);2012—2018年肺结核报告发病率呈现上升趋势(APC=10.8%,P<0.05),2018—2021年肺结核报告发病率呈快速下降趋势(APC=-29.0%,P<0.05)。ITS模型分析显示,和田地区实施“肺结核主动筛查+全疗程住院治疗”模式后1个月(2018年7月),报告发病率增加16.859/10万(P=0.001),新型模式实施后的长期效果为肺结核报告发病率呈下降趋势(β3=-1.098,P<0.001)。CITS模型分析显示,和田地区在新型模式实施后1个月(2018年7月),肺结核报告发病率明显增加,增加量比对照地区高14.751/10万(P<0.001),新型模式实施后长期效果为肺结核报告发病率呈下降趋势,平均每月下降0.815/10万(β5+β7=-0.815,P<0.001),下降速度大于对照地区(β7=-0.931,P<0.001)。结论:新疆和田地区实施“肺结核主动筛查+全疗程住院治疗”模式与肺结核报告发病率之间存在动态因果关系,该模式促使肺结核报告发病率在短暂地上升后呈现下降的长期趋势。实施该模式对控制结核病高负担地区肺结核疫情具有明显优势。
文摘目的:评估2011—2020年四川省结核病防治经费投入产生的社会效益,为制定新时期中长期发展规划提供参考依据。方法:采用回顾性研究方法,从“结核病管理信息系统”和“传染病监测”系统中收集四川省2011—2020年(“十二五”和“十三五”期间)涂阳肺结核患者治疗转归情况和肺结核患者劳动人口比例,结合四川省统计年鉴和全国结核病防治规划终期评估规划自评调查表等获取经费资料和人均国内生产总值(GDP),采用卫生经济学中常用的成本-效果、成本-效用、成本-效益等3种分析方法估算10年间结核病防治经费投入的社会效果、社会效用和社会效益,并对比分析“十二五”和“十三五”期间的估算结果。结果:2011—2020年,四川省共投入结核病防治经费76032.60万元,成功治疗涂阳肺结核患者160167例,避免了696899名健康人受到传染,挽救了1155277个伤残调整寿命年(disability adjusted life year,DALY),为社会节约医疗费用6.05亿元,挽回社会经济损失约370.32亿元。每投入1091.01元即可避免1名健康人被传染,每投入658.13元即可挽回1个DALY,每投入1元即可产生49.50元的社会经济效益。“十三五”期间带来的总社会效益(209.22亿元)较“十二五”期间(167.14亿元)增长了25.18%[(209.22-167.14)/167.14],但政府每投入1元的结核病防治经费产生的社会效益(47.56元)较“十二五”期间(52.17元)减少了4.61元。结论:2011—2020年间各级政府和国际项目对四川省结核病防控工作投入的经费产生了较好的社会效果、效用和效益。建议在保持目前经费投入力度的基础上,各级政府进一步加大投入,尤其对病原学阳性肺结核患者的发现和治疗管理力度,以期产生更高的社会效益。
文摘目的探讨耐多药和利福平耐药肺结核病(multidrug-resistant and rifampin-resistant pulmonary tuberculosis,MDR/RR-PTB)患者的健康相关生命质量(health related quality of life,HRQOL)并分析其影响因素。方法选取2021年至2024年巴中市《结核病管理信息系统》登记治疗管理的50例MDR/RR-PTB患者为耐药组,选取同期该系统登记治疗管理的对抗结核药物治疗敏感的肺结核患者50例作为对照组,采用慢性肺结核患者生命质量测定量表(quality of life instuments for chronic disease pulmonary tuberculosis,QLICD-PT)评估并比较两组患者的HRQOL,用多重线性回归分析法分析影响MDR/RR-PTB患者HRQOL的因素。结果与对照组比较,MDR/RR-PTB组患者除生理功能得分外,其他各模块差异均有统计学意义(P<0.05)。单因素分析结果显示,不同性别、医保类别、家庭月收入、有无合并症、淋巴细胞计数、白蛋白、C反应蛋白、体质量指数的患者QLICD-PT总分差异有统计学意义(P<0.05)。多重线性回归分析结果显示,医保类别、家庭月收入差异有统计学意义(P<0.05)。结论MDR/RR-PTB患者HRQOL低于对抗结核药物敏感的肺结核患者,患者的医保类别、家庭月收入是MDR/RR-PTB患者HRQOL的可能影响因素。
