Person-centred care and short oral treatment for rifampicin-resistant tuberculosis improve retention in care in Kandahar, Afghanistan.

Autor: Mesic A; Médecins Sans Frontières, Amsterdam, The Netherlands.; Institute of Tropical Medicine Antwerp, Antwerp, Belgium., Ishaq S; Médecins Sans Frontières, Kabul, Afghanistan., Khan WH; Médecins Sans Frontières, Kabul, Afghanistan., Mureed A; Médecins Sans Frontières, Kandahar, Afghanistan., Mar HT; Médecins Sans Frontières, Kandahar, Afghanistan., Khaing EE; Médecins Sans Frontières, Kandahar, Afghanistan., Bermudez-Aza E; Médecins Sans Frontières, Amsterdam, The Netherlands., Rose L; Médecins Sans Frontières, Kabul, Afghanistan., Lynen L; Institute of Tropical Medicine Antwerp, Antwerp, Belgium., Seddiq MK; National Tuberculosis Control Programme, Ministry of Public Health, Kabul, Afghanistan., Amirzada HK; National Tuberculosis Control Programme, Ministry of Public Health, Kabul, Afghanistan., Keus K; Médecins Sans Frontières, Amsterdam, The Netherlands., Decroo T; Institute of Tropical Medicine Antwerp, Antwerp, Belgium.; Research Foundation Flanders, Brussels, Belgium.
Jazyk: angličtina
Zdroj: Tropical medicine & international health : TM & IH [Trop Med Int Health] 2022 Feb; Vol. 27 (2), pp. 207-215. Date of Electronic Publication: 2022 Jan 17.
DOI: 10.1111/tmi.13716
Abstrakt: Objectives: To describe the effect of adaptations to a person-centred care with short oral regimens on retention in care for rifampicin-resistant TB (RR-TB) in Kandahar province, Afghanistan.
Methods: The study included people with RR-TB registered in the programme between 01 October 2016 and 18 April 2021. From 19 November 2019, the programme implemented a trial investigating the safety and effectiveness of short oral RR-TB regimens. During the trial, person-centred care was adapted. We included the data from people living with RR-TB treated in the period before and after the care model was adapted and applied Kaplan-Meier statistics to compare rates of retention in care.
Results: Of 236 patients registered in the RR-TB programme, 146 (61.9%) were registered before and 90 (38.1%) after the model of care was adapted. Before adaptations enhancing person-centred care, pre-treatment attrition was 23.3% (n = 34/146), whilst under the adapted care model it was 5.6% (n = 5/90). Attrition on treatment was 22.3% (n = 25/112) before adaptations, whilst during the study period none of the participants were lost-to-follow-up on treatment and 3.3% died (n = 3/90).
Conclusions: As person-centred care delivery and treatment regimens were adapted to better fit-specific contextual challenges and the needs of the target population, retention in care improved amongst people with RR-TB in Kandahar, Afghanistan.
(© 2022 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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