未经评估:耐多药结核病(MDR-TB)的治疗和病例管理是结核病(TB)控制和预防的重大挑战。这项试点研究旨在应用和测试一种新的电子信息系统,以帮助加强耐多药结核病的病例管理。
UNASSIGNED:MDR-TB病例管理系统(CMS)于2017年在云南省结核病临床中心(TCC)开发并试点。接下来,2018年随机抽取云南5个站点作为试点。计算了试点地区的实时定期随访率(RFUR)。通过卡方检验比较了中试和非中试地点之间的MDR-TB治疗队列的随访丢失率(LTFU)。然后通过单变量和多变量二元逻辑回归评估MDR-TB治疗队列的LTFU。
UNASSIGNED:TCC的平均定期随访率分别为90.7%和云南省其他五个试点的73.7%。试点地区的平均LTFU率(9.0%)低于非试点地区(20.6%,P<0.01)。与非试点病例相比,CMS试点病例在MDR-TB治疗期间LTFU的风险降低了61.7%(调整后比值比:0.38,95%置信区间:0.23-0.60)。
UNASSIGNED:作为结核病信息管理系统的重要补充,CMS加强了收集,分析,以及利用耐多药结核病病例的战略信息。该系统通过将其嵌入为综合支持护理服务模型的工具来改进案例管理。
UNASSIGNED: Treatment and case management of multidrug-resistant tuberculosis (MDR-TB) is a significant challenge in tuberculosis (TB) control and prevention. This pilot study aims to apply and test a new electronic information system in order to help bolster case management of MDR-TB.
UNASSIGNED: The MDR-TB Case Management System (CMS) was developed and piloted in the Yunnan Tuberculosis Clinical Center (TCC) in 2017. Next, 5 sites in Yunnan were randomly selected and sampled as pilots in 2018. The real-time regular follow-up rate (RFUR) was calculated for pilot sites. Loss to follow-up (LTFU) rates of MDR-TB treatment cohorts between pilot and non-pilot sites were compared by a chi-square test. LTFU for MDR-TB treatment cohorts was then assessed by univariate and multivariate binary logistic regression.
UNASSIGNED: The average regular follow-up rate was 90.7% in TCC and 73.7% in five other pilot sites of Yunnan Province respectively. The average LTFU rate for pilot sites (9.0%) was lower than non-pilot sites (20.6%, P<0.01). The risk of LTFU during MDR-TB treatment reduced 61.7% in CMS pilot cases (adjusted odds ratio: 0.38, 95% confidence interval: 0.23-0.60) compared with non-pilot cases.
UNASSIGNED: As a significant supplement to the Tuberculosis Information Management System, the CMS strengthened the collection, analysis, and utilization of strategic information for MDR-TB cases. The system improved case management by embedding it as a tool of the Comprehensive Supportive Care service model.