Study On Compliance Status And Intervention Effect Of Anti - Tuberculosis Treatment In Patients With Double Infection Of TB / HIV

Objective To understand adherence of anti-tuberculosis treatment in the TB/HIV co-infection patients, analyzes the influencing factors and evaluate the effect of the intervention on anti-tuberculosis treatment adherence. Methods Retrospective and field investigation were used. Select six counties (districts) of Yunnan province, two of the Hunan province as the field site, collect the previous treatment outcome data to understand the adherence of anti-tuberculosis treatment in TB/HIV co-infection patients in the retrospective survey. In the field investigation, newly detected TB/HIV co-infection patients were enrolled. Information of the patients was collected. Three interventions, i.e. health education, traffic subsidy, telephone reminding and tracing were given to the patients, questionnaire survey was conducted in three periods: before the treatment, at the end of the intensive phase and at the end of the whole treatment. Analyze the influencing factors of anti-tuberculosis treatment adherence and evaluate the effect of the intervention on anti-tuberculosis treatment adherence with the answer of the question and the treatment outcome. Results220patients were enrolled in the retrospective survey and86patients were enrolled in the field investigation1.The successfully treatment rate of the TB/HIV co-infection patients was80.3%, and the default rate was5.0%.2.Whether patients receive ART or not is the influencing factor of treatment adherence (χ2=5.599, P=0.018<0.05),there is no significant statistical difference as for other factors(P>0.05).3.Evaluation of the interventions:.(1)comparison of the newly detected patients’ adherence:the indexes are whether the patient can stick to the treatment at the beginning and at the end of intensive phase, whether the patient can pick up and take medicine on time, whether they feel the success of the treatment is themselves at the end of the intensive phase and at the end of the whole treatment, there is no significant statistical difference between these indexes (P>0.05).(2) comparison of the treatment outcome of the newly detected and the already known TB/HIV co-infection patients;①the successfully treatment rate:the successfully treatment rate of the newly detected patients was87.1%,and that of the known ones was80.3%, there was no significant statistical difference (χ2=1.941, P=0.164>0.05), but as for smear-negative patients, the successfully treatment rate of the newly detected patients was90.1%,and that of the known ones was78.5%,there was a significant statistically difference (χ2=4.116, P=0.042<0.05).②the default rate:the default rate of the newly detected patients was4.4%, and that of the known ones was5.0%, there was no significant statistically difference (χ2=0.000,P=1.000>0.05).Conclusions l.The anti-tuberculosis treatment adherence of TB/HIV co-infection was not optimistic, the successfully treatment rate was low and default rate was high.2. The influencing factors of anti-tuberculosis treatment rate were complex. Anti-tuberculosis treatment should be given as early as possible ART should be given at the right time. Effective measures should be given as for different influencing factors to improve the adherence.3. Three inventions i.e. health education, traffic subsidy, telephone reminding and tracing proved to improve patients’ adherence and treatment outcome.