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如何保证病人完成治疗仍然是结核病控制难以逾越的全球性挑战。自从1993年世界卫生组织引入DOTS以来,直接督导治疗(DOT)已经提升为结核病控制策略的核心内容。三项在非洲、泰国以及巴基斯坦进行的,旨在评价DOT对治疗完成影响的随机对照研究却得出了相互矛盾的结论。到底哪项 研究反映了DOT的真实效果令人无所适从。每项研究的DOT操作方法都与其研究定义不符,在其分析讨论中也没有解释其他干预措施的效果。综合上述证据,尚不能确定哪个因素是应对结核病治疗完成挑战的有效方法。
How to ensure that patients will be treated remains a global challenge insurmountable for tuberculosis control. Since the introduction of DOTS by the World Health Organization in 1993, direct supervisory intervention (DOT) has been elevated to the core of tuberculosis control strategies. Three randomized controlled studies in Africa, Thailand and Pakistan aimed at assessing the impact of DOT on treatment completion have reached conflicting conclusions. Which research reflects the true effect of DOT is at a loss. The DOT method of operation for each study was inconsistent with the definition of the study and did not explain the effectiveness of other interventions in its analysis. Based on the above evidence, it is not clear which factors are effective ways to address the challenge of TB treatment.