結核患者の治療中断に関するリスク要因の分析

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  • Analysis of risk factors associated with defaulting from tuberculosis treatment

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Objectives: To investigate the factors of the Risk Assessment Seat associated with defaulting from tuberculosis treatment.Methods: We use data from "survey of DOTS performance" about new tuberculosis patients received the community DOTS of 31 PHCs in Tokyo in 2008. Chi-square test or Fisher's exact test was used for analysis of the relationship between defaulting from tuberculosis treatment and factors of the Risk Assessment Seat.Results: The defaulting rate of "Homeless", "No supporters", "Has economical problem" and "Has problem of regular outpatient treatment" were significantly higher than that of control group, "Smear positive" and "Has complications" were significantly lower than that of control group. In the analysis by the type of the community DOTS, "Smear positive" by DOTS type A and B were significantly lower than "Smear negative", "Has complications" by DOTS type C was significantly lower than "No complications". "Homeless" and "No supporters" by DOTS type A were significantly higher than that of control group.Conclusions: We considered that lower defaulting rate of "Smear positive" and "Has complications" is related to luck of understanding about TB and medication, so we have to revise the Risk Assessment Seat and the DOTS manual for assessment it. The PHCs have to construct the community DOTS system that the organizations concerned are in cooperation and provide supports in accordance with patient's risk factors because of higher defaulting rate in spite of provided DOTS type A.

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