An Investigation On Clinical Compliance For Treatment Of MDR-TB In Shanxi Province

Purpose:In China, multi-drug resistant tuberculosis (MDR-TB) most commonly develops in the course of TB treatment, and is most commonly due to doctors giving inappropriate treatment. Long treatments, high treatment costs, and low cure rates are characteristic of treatment of MDR-TB. Among the various treatment approaches for MDR-TB, surgery is irreplaceable. While widely accepted as one of the treatment approaches abroad, surgical treatment has not been attached enough importance in China, where the patients are mostly treated with drugs. This study aims to investigate the clinical compliance for surgical treatment of MDR-TB and analyzes its causes to probe reasonable methods of surgical treatment of MDR-TB.Methodology/approach:Investigations into clinical compliance of:MDR-TB patients accepting surgical treatment during 2005 and 2009 at Taiyuan Tuberculosis Hospital and physicians performing surgical treatments at six general and specialized hospitals; qualitative interviews with MDR-TB patients, physicians and surgeons at a tertiary hospital.Findings:As a result it has been seen that the clinical compliance of MDR-TB patients accepting surgical treatment during 2005 and 2009 at Taiyuan Tuberculosis Hospital and physicians performing surgical treatments at six general and specialized hospitals is bad. Two MDR-TB patients accepted surgical treatment during 2005 and 2009 at Taiyuan Tuberculosis Hospital.Conclusions:Causes of bad MDR-TB patients accepting surgical treatment during 2005 and 2009 at Taiyuan Tuberculosis Hospital:1. Due to technical reasons, most MDR-TB cases cannot be diagnosed until the inpatients have come out of the hospital.2. Most MDR-TB patients get out of contact due to hospital transfers or for privacy reasons.3. Most MDR-TB patient fail to receive instructions on surgical treatment from physicians and CDC doctors.4. Physicians of tuberculosis hospitals are reluctant to recommend surgical treatment approaches for the sake of departmental accounting purposes.5. Surgeons at tertiary hospitals are poorly informed, due to lack of treatment instructions, about suitable diseases for surgery.Suggestions:1. Government should put up more investments in quick diagnosis equipment for tuberculosis hospitals.2. Emphasize hospital transfers while delivering the national Stop TB Strategy.3. Standardization of surgical treatment of MDR-TB should be legislated on as soon as possible.