Analysis of treatment completeness and its influencing factors of preventive treatment among 387 latent tuberculosis infection cases

doi:10.19982/j.issn.1000-6621.20240230

Abstract

Abstract:

Objective: To study the treatment completeness and its influencing factors of 3H-P preventive treatment among close contacts of tuberculosis patients with latent tuberculosis infection (LTBI) and to provide a reference for further promotion of preventive treatment. Methods: Between January 1, 2023 and December 31, 2023, 387 LTBI cases who had close contact with tuberculosis patients and received preventive treatment with informed consent from Wushi County, Aksu Prefecture, Xinjiang Uygur Autonomous Region (Xinjiang) were enrolled as research subjects. A questionnaire was used to collect information of the completion of preventive treatment and its influencing factors, mainly including basic demographic information, awareness of tuberculosis prevention and control core knowledge, completion of preventive treatment, etc. Univariable and multivariable logistic regression were used to analyze the influencing factors related to the completion of preventive treatment. Results: Among 387 LTBI cases, 355 completed preventive treatment, with a treatment completion rate of 91.73%. The incidence of adverse reactions was 14.21% (55/387), and 4.39% (17/387) of cases discontinued their treatment due to adverse reactions. Multivariable logistic regression analysis indicated that taking exercise regularly (OR=5.337, 95%CI: 2.309-12.337) and attending training on tuberculosis prevention and control (OR=4.406, 95%CI: 1.942-9.994) were protective factors for completion of preventive treatment, while a history of alcohol consumption (OR=0.279, 95%CI: 0.108-0.720) and aged 50-64 years (OR=0.254, 95%CI: 0.092-0.698) were risk factors for completion of treatment. Conclusion: Completion of preventive treatment among close contacts of tuberculosis patients with LTBI was generally good, with adverse reactions being one of the main reasons for interruption of treatment. The completion rate of their treatment was affected by not exercising regularly, history of alcohol consumption, not attending training on tuberculosis prevention and control, and aged 50-64 years.

Key words: Tuberculosis, pulmonary, Contact tracing, Antitubercular agents, Protective agents, Factor analysis, statistical

CLC Number:

R521

Jiayinati Jingesi, Wang Xinqi, Liu Nianqiang, Wang Senlu, Yipaer Aihaiti, Feng Jianyu, Huang Tao, Kedieryekezi Wufuer. Analysis of treatment completeness and its influencing factors of preventive treatment among 387 latent tuberculosis infection cases[J]. Chinese Journal of Antituberculosis, 2024, 46(12): 1496-1503. doi: 10.19982/j.issn.1000-6621.20240230

Figures/Tables 4

变量	β值	s $x ˉ$ 值	Wald χ²值	P值	OR值	95%CI值
规律运动
是	1.675	0.427	15.347	0.000	5.337	2.309~12.337
否	-	-	-	1.000	-	-
饮酒史
有	-1.276	0.484	6.960	0.008	0.279	0.108~0.720
无	-	-	-	1.000	-	-
参加过结核病防治相关培训
是	1.483	0.418	12.592	0.000	4.406	1.942~9.994
否	-	-	-	1.000	-	-
年龄组(岁)
5~17	-0.498	0.766	0.423	0.515	0.607	0.135~2.728
18~34	-0.368	0.881	0.174	0.676	0.692	0.123~3.892
35~49	0.054	0.765	0.005	0.943	1.056	0.236~4.726
50~64	-1.372	0.517	7.053	0.008	0.254	0.092~0.698
≥65	-	-	-	1.000	-	-

References 27

[1]	Hook EB. Latent Tuberculosis Infection. N Engl J Med, 2022, 386(13): e33. doi:10.1056/NEJMc2200195.
[2]	郭同磊, 辛赫男, 高磊. 《世界卫生组织结核病整合指南模块1:结核病预防性治疗》解读. 中国防痨杂志, 2023, 45(8):723-727. doi:10.19982/j.issn.1000-6621.20230199.
[3]	马艳, 成诗明. 加速我国结核潜伏感染筛查与预防性治疗的建议. 实用医学杂志, 2023, 39(11): 1335-1340. doi:10.3969/j.issn.1006-5725.2023.11.003.
[4]	舒薇, 刘宇红. 世界卫生组织《2023年全球结核病报告》解读. 结核与肺部疾病杂志, 2024, 5 (1): 15-19. doi:10.19983/j.issn.2096-8493.2024006.
[5]	中国防痨协会. 高危人群结核分枝杆菌潜伏感染检测及预防性治疗专家共识. 中国防痨杂志, 2021, 43 (9): 874-878. doi:10.3969/j.issn.1000-6621.2021.09.004.
[6]	中华人民共和国国家卫生和计划生育委员会. WS 288—2017 肺结核诊断. 结核与肺部疾病杂志, 2024, 5 (4): 376-378. doi:10.19983/j.issn.2096-8493.2024022.
[7]	World Health Organization. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva: World Health Organization, 2018.
[8]	徐彩红, 赵雁林. 中国结核病预防性治疗指南. 北京: 人民卫生出版社, 2023: 40-49, 66-69.
[9]	杨蕊, 苏智阳, 刘宜平, 等. 2020年云南省结核病防治核心信息知晓情况及影响因素分析. 中国防痨杂志, 2023, 45(11): 1045-1051. doi:10.19982/j.issn.1000-6621.20230209.
[10]	玛依沙·达肯, 陈阳贵, 李德洋, 等. 2021—2022年乌鲁木齐市肺结核家庭密切接触者预防性治疗意愿的影响因素分析. 预防医学情报杂志, 2023, 39(8): 918-925.
[11]	姚旭, 吴成果, 龚德华, 等. 肺结核患者密切接触者12周预防性治疗方案的服药情况及影响因素分析. 中国防痨杂志, 2021, 43(3): 233-239. doi:10.3969/j.issn.1000-6621.2021.03.008.
[12]	Huang YW, Yang SF, Yeh YP, et al. Impacts of 12-dose regimen for latent tuberculosis infection: Treatment completion rate and cost-effectiveness in Taiwan. Medicine (Baltimore), 2016, 95(34): e4126. doi:10.1097/MD.0000000000004126.
[13]	Walker RE, Bass S, Srinivas P, et al. Evaluation of 3 Months of Once-Weekly Rifapentine and Isoniazid for Latent Tuberculosis Infection. Ann Pharmacother, 2020, 54(5): 457-463. doi:10.1177/1060028019888855. pmid: 31729245
[14]	Swift MD, Molella RG, Vaughn AIS, et al. Determinants of Latent Tuberculosis Treatment Acceptance and Completion in Healthcare Personnel. Clin Infect Dis, 2020, 71(2): 284-290. doi:10.1093/cid/ciz817. pmid: 31552416
[15]	Kim A, Choi M. Factors Influencing the Diagnosis and Treatment of Latent Tuberculosis among Contacts in Congregated Settings in Korea. J Korean Med Sci, 2019, 34(18): e138. doi:10.3346/jkms.2019.34.e138.
[16]	Onwubiko U, Wall K, Sales RM, et al. Using Directly Observed Therapy (DOT) for latent tuberculosis treatment-A hit or a miss? A propensity score analysis of treatment completion among 274 homeless adults in Fulton County, GA. PLoS One, 2019, 14(6): e0218373. doi:10.1371/journal.pone.0218373.
[17]	Semitala FC, Kadota JL, Musinguzi A, et al. Comparison of 3 optimized delivery strategies for completion of isoniazid-rifapentine (3HP) for tuberculosis prevention among people living with HIV in Uganda: A single-center randomized trial. PLoS Med, 2024, 21(2): e1004356. doi:10.1371/journal.pmed.1004356.
[18]	Sterling TR, Villarino ME, Borisov AS, et al. Three months of rifapentine and isoniazid for latent tuberculosis infection. N Engl J Med, 2011, 365(23): 2155-2166. doi:10.1056/NEJMoa1104875.
[19]	Villa S, Ferrarese M, Sotgiu G, et al. Latent Tuberculosis Infection Treatment Completion while Shifting Prescription from Isoniazid-Only to Rifampicin-Containing Regimens: A Two-Decade Experience in Milan, Italy. J Clin Med, 2019, 9(1): 101. doi:10.3390/jcm9010101.
[20]	Rahman MT, Hossain F, Banu RS, et al. Uptake and Completion of Tuberculosis Preventive Treatment Using 12-Dose, Weekly Isoniazid-Rifapentine Regimen in Bangladesh: A Community-Based Implementation Study. Trop Med Infect Dis, 2023, 9(1): 4. doi:10.3390/tropicalmed9010004.
[21]	Sharma N, Bakshi R, Basu S, et al. Implementation of tuberculosis preventive therapy with INH-Rifapentine (3HP) for latent tuberculosis infection management in household tuberculosis contacts in India: A prospective study. Trop Med Int Health, 2023, 28(12): 890-900. doi:10.1111/tmi.13940. pmid: 37864386
[22]	Schein YL, Madebo T, Andersen HE, et al. Treatment completion for latent tuberculosis infection in Norway: a prospective cohort study. BMC Infect Dis, 2018, 18(1): 587. doi:10.1186/s12879-018-3468-z.
[23]	Kunin M, Timlin M, Lemoh C, et al. Improving screening and management of latent tuberculosis infection: development and evaluation of latent tuberculosis infection primary care model. BMC Infect Dis, 2022, 22(1): 49. doi:10.1186/s12879-021-06925-8.
[24]	Yang H, Yang Y, Hu ZD, et al. High rate of completion for weekly rifapentine plus isoniazid treatment in Chinese children with latent tuberculosis infection-A single center study. PLoS One, 2021, 16(6): e0253159. doi:10.1371/journal.pone.0253159.
[25]	Sun HY, Huang YW, Huang WC, et al. Twelve-dose weekly rifapentine plus isoniazid for latent tuberculosis infection: A multicentre randomised controlled trial in Taiwan. Tuberculosis (Edinb), 2018, 111: 121-126. doi:10.1016/j.tube.2018.05.013.
[26]	Eastment MC, McClintock AH, McKinney CM, et al. Factors That Influence Treatment Completion for Latent Tuberculosis Infection. J Am Board Fam Med, 2017, 30(4): 520-527. doi:10.3122/jabfm.2017.04.170070. pmid: 28720633
[27]	万莹. 基层医疗卫生机构开展结核病健康教育的研究进展. 结核与肺部疾病杂志, 2023, 4(5): 432-436. doi:10.19983/j.issn.2096-8493.20230079.

特征	服药人数(名)	构成比(%)
性别
男性	178	45.99
女性	209	54.01
年龄组(岁)
5~17	44	11.37
18~34	35	9.04
35~49	62	16.02
50~64	112	28.94
≥65	134	34.63
婚姻状况
已婚	268	69.25
未婚/离婚/丧偶	119	30.75
教育程度
初中及以下	309	79.84
高中及以上	78	20.16
家庭年收入(万元)
<3	197	50.90
≥3	190	49.10
合并慢性病
是	220	56.85
否	167	43.15
接种卡介苗
是	264	68.22
否	123	31.78
饮酒史
有	46	11.89
无	341	88.11
规律运动
是	289	74.68
否	98	25.32
吸烟史
有	71	18.35
无	316	81.65
参加过结核病防治相关培训
是	280	72.35
否	107	27.65
家庭住址与当地定点医院距离(km)
<3	228	58.91
≥3	159	41.09
结核病防治核心知识知晓情况
良好	341	88.11
较差	46	11.89
密切接触者与肺结核患者的关系
家庭内	232	59.95
家庭外	155	40.05

因素		服药人数(名)		完成服药人数(名)	服药完成率(%)	χ²值	P值
性别						0.071	0.790
男性		178		164	92.13
女性		209		191	91.39
年龄组(岁)						10.073	0.039
5~17		44		41	93.18
18~34		35		33	94.29
35~49		62		59	95.16
50~64		112		95	84.82
≥65		134		127	94.78
婚姻状况						0.542	0.462
已婚		268		244	91.04
未婚/离婚/丧偶		119		111	93.28
教育程度						0.445	0.505
初中及以下		309		282	91.26
高中及以上		78		73	93.59
年收入(万元)						0.069	0.793
<3		197		180	91.37
≥3		190		175	92.11
合并慢性病						0.197	0.657
是		220		203	92.27
否		167		152	91.02
接种卡介苗						0.005	0.946
是		264		242	91.67
否		123		113	91.87
饮酒史						8.783	0.003
有		46		37	80.43
无		341		318	93.26
规律运动						14.259	0.000
是		289		274	94.81
否		98		81	82.65
吸烟史						0.290	0.590
有	71		64		90.14
无	316		291		92.09
参加过结核病防治相关培训						11.319	0.001
是	280		265		94.64
否	107		90		84.11
家庭住址与当地定点医院距离(km)						0.649	0.420
<3	228		207		90.79
≥3	159		148		93.08
结核病防治核心知识知晓情况						1.058	0.304
良好	341		311		91.20
较差	46		44		95. 65
密切接触者与肺结核患者的关系						2.067	0.151
家庭内	232		209		90.09
家庭外	155		146		94.19

变量名称	赋值情况	变量名称	赋值情况
完成服药	否=0,是=1	参加过结核病防治相关培训	否=0,是=1
规律运动	否=0,是=1	年龄(岁)	5~17=1; 18~34=2; 35~49=3; 50~64=4;≥65= 0
饮酒史	无=0,有=1	年龄(岁)	5~17=1; 18~34=2; 35~49=3; 50~64=4;≥65= 0