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背景:Taif胸科医院,沙特阿拉伯,Taif.目的:抗结核药物治疗的不合作性被认为是治疗失败、耐药和复发的主要原因。在沙特阿拉伯,不合作问题很常见,其严重性需立即引起卫生权威人士的关注。本研究的目的是确定影响合作率的因素并采取适当的方法以改变这些因素。设计:在本国西部地区的一所大胸科医院,早期住院治疗期之后,设计并试用了一套补救系统,以改善病人随访和取药方法。结果:在628例病人中,358例(57％)未参加首次门诊复诊。补救系统仅使83例病人回诊所就诊,只降低丢失率13.2%。对仍不合作的275例(43.8％)病人的可能影响其合作性的诸因素进行了分析。结论:由于要改变这些影响因素很困难,我们强烈支持在沙特阿拉伯和面临类似结核病控制问题的其他国家实施由WHO推荐的直接观察下的治疗(DOT) 策略。
Background: Taif Thoracic Hospital, Saudi Arabia, Taif. Purpose: Noncooperative treatment of anti-TB drugs is considered to be a major cause of treatment failure, drug resistance and relapse. In Saudi Arabia, the problem of non-cooperation is common and the seriousness of it immediately demands the attention of health authorities. The purpose of this study is to identify the factors that affect the rate of cooperation and take appropriate measures to change these factors. Design: In a large chest hospital in the western part of the country, a set of remediation systems were designed and tested following early hospitalization to improve patient follow-up and medication taking. Results: Of the 628 patients, 358 (57%) did not attend the first outpatient referral. The remedial system returned only 83 patients to the clinic, only reducing the loss rate by 13.2%. 275 factors (43.8%) who were still uncooperative were analyzed for the factors that may affect their co-operation. Conclusion: Due to the difficulty of changing these factors, we strongly support the direct observation-based treatment (DOT) strategy recommended by the WHO in Saudi Arabia and other countries facing similar TB control issues.