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Follow-up and tracing of tuberculosis patients who fail to attend their scheduled appointments in Cotonou, Benin: a retrospective cohort study

机译:在贝宁科托努未按计划赴约的结核病患者的随访和追踪:一项回顾性队列研究

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In the “Centre National Hospitalier de Pneumo-Phtisiologie” of Cotonou, Benin, little is known about the characteristics of patients who have not attended their scheduled appointment, the results of tracing and the possible benefits on improving treatment outcomes. This study aimed to determine the contribution of tracing activities for those who missed scheduled appointments towards a successful treatment outcome. A retrospective cohort study was carried out among all smear-positive pulmonary tuberculosis patients treated between January and September 2013. Data on demographic and diagnostic characteristics and treatment outcomes were accessed from tuberculosis registers and treatment cards. Information on those who missed their scheduled appointments was collected from the tracing tuberculosis register. A univariate analysis was performed to explore factors associated with missing a scheduled appointment. Of 457 patients (410 new smear-positive and 47 retreatment tuberculosis), 37 (8?%) missed one or more of their appointments with a total of 44 episodes of missed appointments. The 3.5th (32?%) and 5th (43?%) month appointments were the ones most likely to be missed. Being male was associated with a higher risk of missing appointments (RR?=?4.2; 95 % CI?=?1.5–11.8, p?=?0.004) while having HIV infection was associated with a lower risk (RR?=?0.3, 95 % CI?=?0.1–0.9, p?=?0.03). Principal reasons for missed appointments were travelling outside Cotonou (34?%) and feeling better (21?%). In 24 (55?%) of these 44 episodes of missed appointments, contact was made with the patient who returned to the programme. These follow-up activities increased the treatment success by 4?%. In Cotonou, Benin, less than 10?% of tuberculosis patients miss at least one of their scheduled appointments. Tracing activities increase the treatment success rate by 4?% and current on-going practices in the Programme need to be endorsed and encouraged.
机译:在贝宁科托努的“国家肺部疾病医院精神病学中心”,人们对未参加预定约会的患者的特征,追踪结果以及改善治疗效果的可能益处知之甚少。这项研究旨在确定追踪活动对错过预定约会的人对成功治疗结果的贡献。对2013年1月至2013年9月接受治疗的所有涂片阳性肺结核患者进行了一项回顾性队列研究。可从结核病登记簿和治疗卡中获得有关人口统计学和诊断特征以及治疗结果的数据。从追踪结核病登记处收集了有关错过预定约会的人员的信息。进行了单变量分析,以探讨与错过预定约会相关的因素。在457名患者(410名新涂片阳性和47例再治疗结核病)中,有37名(占8%)错过了一项或多项约会,总共错过了44次约会。最有可能被遗漏的是第3.5个约会(32%)和第5个约会(43 %%)。男性是与约会失败相关的较高风险(RR?=?4.2; 95%CI?=?1.5-11.8,p?=?0.004),而艾滋病毒感染的风险较低(RR?=?0.3)。 ,95%CI≤0.1-0.9,p≤0.03)。错过约会的主要原因是在科托努(34%)之外旅行并感觉更好(21 %%)。在这44次错过约会中,有24次(占55%)与返回该计划的患者进行了联系。这些后续活动使治疗成功率提高了4%。在贝宁的科托努,不到10%的结核病患者错过了至少一项预定的约会。追踪活动使治疗成功率提高了4%,并且需要批准和鼓励该计划中的现行实践。

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