背景:尽管摩洛哥免费提供结核病(TB)护理,大量患者在治疗结束前自愿中断治疗。治疗违约是对抗疾病的主要障碍。这项研究的目的是描述对结核病的知识和态度对治疗依从性的影响。
方法:病例对照研究,纳入290例结核病患者(85名违约者和205名对照者)。违约者被定义为中断治疗两个月或更长时间的结核病患者。社会人口统计学测量,通过面对面匿名问卷收集知识和态度。进行了Khi平方检验,以根据治疗依从性检查结核病态度和知识的差异。
结果:参与者的平均年龄为31.7±12.0岁。其中82%的月收入低于2000MAD(180欧元)。超过64%的人是文盲或具有基础教育水平。17.2%的受访者知道微生物原因;粘附患者中20.5%对9.4%(p=0.02)。粘附患者更了解该疾病是可治愈的事实:99.0%对88.2%(p<0.01)。80%的患者被告知治疗持续时间和未完成治疗的后果:粘附患者中的89.0%对69.7%(p<0.001)。引发违约的主要原因是被治愈的感觉(72.9%的违约者)。
结论:这项研究表明,对结核病的认识不足,尤其是在非粘附患者中。这一发现证明了将患者教育纳入当前结核病病例管理的必要性。
BACKGROUND: Although tuberculosis (TB) care is provided free of charge in Morocco, a high number of patients voluntarily interrupt their treatment before the end. Treatment Default is a major obstacle in the fight against the disease. The purpose of this study was to describe the impact of knowledge and attitudes toward TB on treatment adherence.
METHODS: Case-control study of 290 TB patients (85 defaulters and 205 controls). A defaulter was defined as a TB patient who interrupted treatment for two months or longer. Socio-demographic measurements, knowledge and attitude were collected by face to face anonymous questionnaire. Khi-square test was conducted to examine differences in TB attitudes and knowledge according to treatment adherence.
RESULTS: The mean age of participants was 31.7 ± 12.0 years. Monthly income was under 2000 MAD (180 €) for 82% of them. Over sixty four percent were illiterate or had a basic educational level. Microbial cause was known by 17.2% respondents; 20.5% among adherent patients versus 9.4% (p=0.02). The fact that the disease is curable was more known by adherent patients: 99.0% versus 88.2% (p < 0.01). Eighty tree per cent of patients had been informed about treatment duration and consequences of not completing treatment: 89.0% among adherent patients versus 69.7% (p<0.001). The main reason evoked for defaulting was the sensation of being cured (72.9% of defaulters).
CONCLUSIONS: This study shows a poor knowledge on TB especially among non adherent patients. This finding justifies the need to incorporate patient\'s education into current TB
case management.