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中国防痨杂志 ›› 2025, Vol. 47 ›› Issue (11): 1426-1432.doi: 10.19982/j.issn.1000-6621.20250200

• 论著 • 上一篇    下一篇

电子药盒辅助学生结核分枝杆菌潜伏感染者进行结核病预防性治疗的可行性

秦楠1, 刘磊2, 吴哲渊3, 邓倩2, 陈静1, 陈彬4, 陈诚5, 张天圆1, 陈昊2(), 沈鑫3()   

  1. 1上海市疾病预防控制中心结核病与艾滋病防治所结核病防治科,上海 201107
    2新疆维吾尔自治区伊犁哈萨克自治州伊宁市疾病预防控制中心,伊宁 835000
    3上海市疾病预防控制中心结核病与艾滋病防治所,上海 201107
    4浙江省疾病预防控制中心,杭州 310051
    5江苏省疾病预防控制中心,南京 210009
  • 收稿日期:2025-05-15 出版日期:2025-11-10 发布日期:2025-10-30
  • 通信作者: 陈昊,沈鑫 E-mail:1179865882@qq.com;shenxin@scdc.sh.cn
  • 基金资助:
    上海市加强公共卫生体系建设三年行动计划(GWVI-11.1-05);上海市加强公共卫生体系建设三年行动计划(GWVI-11.2-XD07);2023年东方英才计划拔尖项目(2023—2025);上海市卫生健康委员会科研课题(20254Y0075)

Feasibility study on the use of electronic pillboxes to assist students with latent tuberculosis infection in preventive medication

Qin Nan1, Liu Lei2, Wu Zheyuan3, Deng Qian2, Chen Jing1, Chen Bin4, Chen Cheng5, Zhang Tianyuan1, Chen Hao2(), Shen Xin3()   

  1. 1Section of Tuberculosis Control and Prevention, Department of Tuberculosis and AIDS Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 201107, China
    2Yining Center for Disease Control and Prevention, Yili Kazak Autonomous Prefecture, Xinjiang Uygur Autonomous Region, Yining 835000, China
    3Department of Tuberculosis and AIDS Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 201107, China
    4Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
    5Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
  • Received:2025-05-15 Online:2025-11-10 Published:2025-10-30
  • Contact: Chen Hao,Shen Xin E-mail:1179865882@qq.com;shenxin@scdc.sh.cn
  • Supported by:
    Shanghai’s Three-year Action Plan to Strengthen the Construction of Public Health System(GWVI-11.1-05);Shanghai’s Three-year Action Plan to Strengthen the Construction of Public Health System(GWVI-11.2-XD07);Shanghai Oriental Talents Plan Top-notch Project(2023—2025);Shanghai Municipal Health Commission Research Project(20254Y0075)

摘要:

目的: 探索电子药盒辅助学生结核分枝杆菌潜伏感染(latent tuberculosis infection,LTBI)者开展结核病预防性治疗(tuberculosis preventive therapy,TPT)的可行性,为相关技术推广应用提供科学依据。方法: (1)纳入2023年9月新疆维吾尔自治区伊犁哈萨克自治州(简称“新疆伊犁州”)伊宁市卫生学校入学体检中发现为LTBI且符合TPT条件,并使用电子药盒辅助TPT的25例学生为研究对象,分析TPT的完成率及依从性。(2)采用目的抽样方法,选取伊宁市疾病预防控制中心结防科工作人员、校医,以及使用电子药盒进行服药打卡的学生LTBI者等,共7名(例),进行面对面半结构式访谈,访谈内容主要包括使用电子药盒辅助TPT的影响因素及可行性等。结果: 25例使用电子药盒辅助TPT的学生LTBI者中,完成TPT者15例(60%);应服药总次数为2077次,实际服药次数为1697次,服药率为81.70%,其中,主动打卡917次,主动打卡率为44.15%。TPT第1个月的服药率为99.42%(691/695),主动打卡率为73.09%(508/695),第3个月的服药率为57.71%(434/752),主动打卡率为23.01%(173/752)。随着治疗时间增加,服药率及主动打卡率均明显下降,差异均有统计学意义(χ2=-19.078,P<0.05;χ2=-20.652,P<0.05)。排除电子药盒由于设备技术问题导致无法正常使用的情况后,应服药总次数为1209次,实际服药次数为1083次,服药率为89.58%,其中,主动打卡次数为874次,主动打卡率为72.29%;服药率和主动打卡率均明显高于未排除设备技术问题的情况,差异均有统计学意义(χ2=35.765,P<0.05;χ2=242.910,P<0.05)。访谈结果显示,使用体验、基础设施、培训和沟通等3个方面均对电子药盒辅助学生LTBI者实施TPT产生影响。结论: 应用电子药盒辅助学生LTBI者开展TPT具有可行性,电子药盒在TPT中的推广应用需要当地加强基础设施资源建设,加强健康宣教,及时解决使用过程中存在的技术问题。

关键词: 分枝杆菌,结核, 感染, 治疗应用, 预防卫生服务, 电子药盒

Abstract:

Objective: To explore the feasibility of electronic pillboxes assisting students with latent tuberculosis infection (LTBI) to carry out tuberculosis preventive therapy (TPT), so as to provide scientific basis for the promotion and application of related technologies. Methods: (1) Twenty-five students who were found to have LTBI during the physical examination for admission to Yining Health School in Ili Kazakh Autonomous Prefecture, Xinjiang Uygur Autonomous Region in September 2023 and met the TPT criteria, and used electronic pillboxes to assist TPT, were included as the research subjects to analyze the completion rate and compliance of TPT. (2) Using purposive sampling method, a total of 7 individuals were selected from the staff of the Tuberculosis Prevention Department of Yining City Center for Disease Control and Prevention, school doctors, and LTBI students who use electronic pillboxes for medication check-in. Face to face semi-structured interviews were conducted, mainly focusing on the influencing factors and feasibility of using electronic pillboxes to assist TPT. Results: Among the 25 students who used electronic pillboxes to assist with TPT for LTBI, 15 (60%) completed TPT; the total number of times medication should be taken was 2077, and the actual number of times medication should be taken was 1697, with a medication rate of 81.70%. Among them, there were 917 active check-ins, with an active check-in rate of 44.15%. The medication rate in the first month of TPT was 99.42% (691/695), with an active check-in rate of 73.09% (508/695). In the third month, the medication rate was 57.71% (434/752), with an active check-in rate of 23.01% (173/752). With the increase of treatment time, the medication rate and active check-in rate both significantly decreased, and the differences were statistically significant (χ2=-19.078, P<0.05; χ2=-20.652, P<0.05). After excluding the situation where the electronic pillbox cannot be used normally due to equipment technical issues, the total number of times medication should be taken was 1209, and the actual number of times medication was taken was 1083, with a medication rate of 89.58%. Among them, the number of active check-in times was 874, and the active check-in rate was 72.29%; the medication rate and active check-in rate were significantly higher than those without excluding equipment technical problems, and the differences were statistically significant (χ2=35.765, P<0.05; χ2=242.910, P<0.05). The interview results showed that user experience, infrastructure, training, and communication, all had an impact on the implementation of TPT by electronic pillboxes assisted student LTBI. Conclusion: The application of electronic pillboxes to assist LTBI students in conducting TPT is feasible. The promotion and application of electronic pillboxes in TPT requires local efforts to strengthen infrastructure resource construction, enhance health education, and promptly solve technical problems that may arise during use.

Key words: Mycobacterium tuberculosis, Infection, Therapeutic uses, Preventive health services, Electronic pillboxes

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