Abstract：
BACKGROUND: Adherence is often a barrier to curative treatment of Mycobacterium tuberculosis (TB). There have been numerous interventions focused on increasing TB treatment adherence in Southeast Asia, but it is unclear if they are effective. This systematic review and meta-analysis aimed to compile and evaluate the literature on interventions designed to increase TB treatment adherence in Southeast Asia.
METHODS: We searched Cochrane Library Reviews (CDSR) and Cochrane Library Trials (CENTRAL), Medline, CINAHL, Scopus, and Web of Science from 2000 to 2022 with no language restrictions. We included studies of any design conducted in Southeast Asia that implemented interventions to increase treatment completion in people diagnosed with TB and assessed completion as an outcome. We did not require a control group. Four investigators used a standardized data collection form to collate results. The heterogeneity across studies was explored by I2 statistics. We assessed bias using the Newcastle-Ottawa Scale and Cochrane ROB 2.0. We used a random effects meta-analysis to calculate a pooled risk ratio with 95% confidence intervals.
RESULTS: From 1881 abstracts, we included 14 articles. There were 7198 subjects with 3163 (44%) receiving a TB treatment adherence intervention across eight countries. Interventions included directly observed therapy, text-message reminders, food incentives, and more. The risk ratio, derived from the meta-analysis of eight included studies with a control group and 6618 participants overall, was 1.04 (95% CI 1.01,1.08; I2 = 29%), favoring the interventions over controls with little concern for heterogeneity or risk of bias. When narratively assessed, the other six studies all reported increased adherence in the intervention group.
CONCLUSIONS: The results suggested there is a small, statistically significant benefit of using interventions to promote TB treatment completion. Future research could look at additional strategies and combinations of strategies to promote adherence.
METHODS: We searched Cochrane Library Reviews (CDSR) and Cochrane Library Trials (CENTRAL), Medline, CINAHL, Scopus, and Web of Science from 2000 to 2022 with no language restrictions. We included studies of any design conducted in Southeast Asia that implemented interventions to increase treatment completion in people diagnosed with TB and assessed completion as an outcome. We did not require a control group. Four investigators used a standardized data collection form to collate results. The heterogeneity across studies was explored by I2 statistics. We assessed bias using the Newcastle-Ottawa Scale and Cochrane ROB 2.0. We used a random effects meta-analysis to calculate a pooled risk ratio with 95% confidence intervals.
RESULTS: From 1881 abstracts, we included 14 articles. There were 7198 subjects with 3163 (44%) receiving a TB treatment adherence intervention across eight countries. Interventions included directly observed therapy, text-message reminders, food incentives, and more. The risk ratio, derived from the meta-analysis of eight included studies with a control group and 6618 participants overall, was 1.04 (95% CI 1.01,1.08; I2 = 29%), favoring the interventions over controls with little concern for heterogeneity or risk of bias. When narratively assessed, the other six studies all reported increased adherence in the intervention group.
CONCLUSIONS: The results suggested there is a small, statistically significant benefit of using interventions to promote TB treatment completion. Future research could look at additional strategies and combinations of strategies to promote adherence.
摘要：
背景：坚持通常是结核分枝杆菌（TB）治愈性治疗的障碍。在东南亚，有许多干预措施专注于提高结核病治疗的依从性。但目前尚不清楚它们是否有效。本系统综述和荟萃分析旨在汇编和评估有关旨在提高东南亚结核病治疗依从性的干预措施的文献。
方法：我们搜索了Cochrane图书馆评论（CDSR）和Cochrane图书馆试验（CENTRAL），Medline,CINAHL,Scopus,和WebofScience从2000年到2022年，没有语言限制。我们纳入了在东南亚进行的任何设计的研究，这些设计实施了干预措施以提高被诊断为结核病的人的治疗完成度，并评估了完成度作为结果。我们不需要对照组。四名调查人员使用标准化的数据收集表格来整理结果。通过I2统计来探索研究之间的异质性。我们使用纽卡斯尔-渥太华量表和CochraneROB2.0评估偏倚。我们使用随机效应荟萃分析来计算具有95％置信区间的合并风险比。
结果：来自1881年摘要，我们包括14篇文章。在八个国家/地区，有7198名受试者和3163名（44％）接受了结核病治疗依从性干预。干预措施包括直接观察治疗，短信提醒,食品激励措施，还有更多.风险比率，来自对8项纳入研究的荟萃分析，对照组和6618名参与者，为1.04（95%CI1.01,1.08；I2=29%），有利于干预措施而不是控制，几乎不关心异质性或偏见风险。当叙述评估时，其他6项研究均报告干预组的依从性增加.
结论：结果表明，使用干预措施促进完成结核病治疗的显著益处。未来的研究可以着眼于其他策略和策略的组合，以促进依从性。
方法：我们搜索了Cochrane图书馆评论（CDSR）和Cochrane图书馆试验（CENTRAL），Medline,CINAHL,Scopus,和WebofScience从2000年到2022年，没有语言限制。我们纳入了在东南亚进行的任何设计的研究，这些设计实施了干预措施以提高被诊断为结核病的人的治疗完成度，并评估了完成度作为结果。我们不需要对照组。四名调查人员使用标准化的数据收集表格来整理结果。通过I2统计来探索研究之间的异质性。我们使用纽卡斯尔-渥太华量表和CochraneROB2.0评估偏倚。我们使用随机效应荟萃分析来计算具有95％置信区间的合并风险比。
结果：来自1881年摘要，我们包括14篇文章。在八个国家/地区，有7198名受试者和3163名（44％）接受了结核病治疗依从性干预。干预措施包括直接观察治疗，短信提醒,食品激励措施，还有更多.风险比率，来自对8项纳入研究的荟萃分析，对照组和6618名参与者，为1.04（95%CI1.01,1.08；I2=29%），有利于干预措施而不是控制，几乎不关心异质性或偏见风险。当叙述评估时，其他6项研究均报告干预组的依从性增加.
结论：结果表明，使用干预措施促进完成结核病治疗的显著益处。未来的研究可以着眼于其他策略和策略的组合，以促进依从性。
