TB treatment using family members, treatment supporters and self-administered therapies in rural Papua New Guinea.

IF 1.3 Q4 RESPIRATORY SYSTEM Public Health Action Pub Date : 2023-06-21 DOI:10.5588/pha.22.0062

G Kurbaniyazova, F Msibi, H Bogati, M Kal, A Sofa, E Abdi Djama, P Mozi, F Hossain, P Blasco, L Sannino

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引用次数: 1

Abstract

Setting: Papua New Guinea (PNG) has one of the world's highest TB incidence rates. It is difficult for patients to access TB care in remote provinces due to insufficient infrastructure and challenging terrain, making varied, targeted delivery models for treating TB necessary.

Objective: To assess treatment outcomes using self-administered treatment (SAT), family-supported treatment and community-based directly observed therapy (DOT) via treatment supporter (TS) in the PNG context.

Design: A retrospective, descriptive analysis of routinely collected data from 360 patients at two sites in 2019-2020. All patients were assigned a treatment model based on risk factors (adherence or default) and offered patient education and counselling (PEC), family counselling and transportation fees. End-of-treatment outcomes were assessed for each model.

Results: Treatment success rates among drug-susceptible TB (DS-TB) were good overall: 91.1% for SAT, 81.4% for family-supported treatment and 77% for DOT patients. SAT was strongly associated with favourable outcomes (OR 5.7, 95% CI 1.7-19.3), as were PEC sessions (OR 4.3, 95% CI 2.5-7.2).

Conclusion: By considering risk factors when determining their treatment delivery model, strong outcomes were seen in all three groups. Multiple modes of treatment administration, tailored to individuals' needs and risk factors, is a feasible, effective, patient-centred care model for hard-to-reach, resource-limited settings.

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在巴布亚新几内亚农村地区，利用家庭成员、治疗支持者和自我治疗进行结核病治疗。

环境:巴布亚新几内亚是世界上结核病发病率最高的国家之一。在偏远省份，由于基础设施不足和地形复杂，患者很难获得结核病治疗，因此必须采用多种有针对性的结核病治疗模式。目的:评估PNG背景下自我给予治疗(SAT)、家庭支持治疗和社区直接观察治疗(DOT)的治疗效果。设计:对2019-2020年两个地点360名患者常规收集的数据进行回顾性描述性分析。根据风险因素(依从性或默认)为所有患者分配治疗模式，并提供患者教育和咨询(PEC)、家庭咨询和交通费。对每个模型的治疗结束结果进行评估。结果:药物敏感结核病(DS-TB)的治疗成功率总体良好:SAT治疗为91.1%，家庭支持治疗为81.4%，DOT治疗为77%。SAT与有利结果密切相关(OR 5.7, 95% CI 1.7-19.3)， PEC疗程也是如此(OR 4.3, 95% CI 2.5-7.2)。结论:通过在确定治疗交付模式时考虑危险因素，三组患者均获得了良好的治疗效果。针对个人需求和风险因素量身定制的多种治疗管理模式，是一种可行、有效、以患者为中心的护理模式，适用于交通不便、资源有限的环境。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.