Community-involved strategy to improve tuberculosis (TB) treatment outcomes in Eastern Region of Ghana

スポンサーリンク

概要

• 論文の詳細を見る

• Objective: To evaluate decentralization and community supervision of tuberculosis treatment as an effective intervention to improve treatment outcomes in Eastern Region of Ghana.Methods: A historical comparison of treatment outcomes of cohorts registered in 2003-2005 with centralized Directly Observed Treatment short course (DOTs) at health facility level and cohorts registered in 2007-2009 with decentralized DOTs at the community level. Effectiveness was measured by comparing TB case finding and treatment outcomes before and after the introduction of the decentralization with participation of local communities providing the option of treatment supervision.Results: In total 5128 cases were registered during the centralized period with 60% being men and 40% women. In the decentralized period 5309 cases were recorded with 62.7% men and 37.3% women. Among new smear-positive cases there was a significant difference between treatment success rates in the decentralized period as compared to the centralized period (82.7% vs 69.6%, respectively: p-value < 0.0001). Cured rate improved during the decentralized period as against the centralized period (75.8% vs 63.2%, respectively; p-value < 0.0001). Defaulter rate significantly reduced in the decentralized period as compared to the centralized period (3.6% vs 12.1%, respectively; p-value < 0.0001). Among new smear negative-and extra pulmonary TB patients, treatment completion rate was significantly higher in the decentralized period than in the centralized period (80.2% vs 56.3%, respectively; p-value < 0.0001) and defaulter rate was significantly reduced in the decentralized period than in the centralized period (3.3% vs 17.7%, respectively; p-value < 0.0001) Conclusion: Decentralization of TB treatment to the community level, empowering TB patients to choose treatment supporters from the community and communities providing treatment supervision till cure, improved treatment outcomes in Eastern Region of Ghana.

• 国立保健医療科学院の論文
• 2012-08-00

著者

• Sata Fumihiro

  Department Of Public Health Hokkaido University Graduate School Of Medicine

• Osawa Eri

  Department of International Health and Collaboration, National Institute of Public Health

• BOATENG Samuel

  Eastern Regional Health Administration, Ghana

• KODAMA Tomoko

  Guest Researcher, Department of International Health and Collaboration, National Institute of Public Health

• Bonsu George

  Eastern Regional Health Adminigtration, Kotoridua, Ghana

• Sata Fumihiro

  Department of Environmental Health, National Institute of Public Health

関連論文

• Effects of the Interaction between Interleukin-6 -634C/G Polymorphism and Smoking on Serum C-Reactive Protein Concentrations(インターロイキン6-634C/G多型と喫煙との相互作用が、血清中C反応性タンパク質濃度に及ぼす作用)
• Inflammation as a cardiovascular risk factor and pulse wave velocity as a marker of early-stage atherosclerosis in the Japanese population
• Genistein-Induced Changes in Gene Expression in Panc 1 Cells at Physiological Concentrations of Genistein
• Near-Infrared Spectrophotometry Is Useful to Detect the Beneficial Pharmacological Effects of Alprostadil on Spinal Cord Deoxygenation
• Indoor Airborne Mold Spores in Newly Built Dwellings
• The Estimated Prevalence of Hypospadias in Hokkaido, Japan
• Effects of Pregnancy, Age and Sex in the Metabolism of Styrene in Rat Liver in Relation to the Regulation of Cytochrome P450 Enzymes
• Community-involved strategy to improve tuberculosis (TB) treatment outcomes in Eastern Region of Ghana

スポンサーリンク