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研究生: 張惠美
Chang, Hui-Mei
論文名稱: 比較兩種潛伏結核感染治療期程與都治介入方案之完治率─以臺北市為例
Completion Rate of Two Regimens and DOPT for Latent Tuberculosis Infection Treatment in Taipei City
指導教授: 葉國樑
Yeh, Gwo-Liang
曾治乾
Tseng, Chie-Chien
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2018
畢業學年度: 106
語文別: 中文
論文頁數: 70
中文關鍵詞: 3HP健康信念模式都治結核病潛伏結核感染治療
英文關鍵詞: 3HP, DOPT, Health believe model, Treatment of latent tuberculosis infection, Tuberculosis
DOI URL: http://doi.org/10.6345/THE.NTNU.DHPHE.009.2018.F02
論文種類: 學術論文
相關次數: 點閱:135下載:4
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  • 潛伏結核感染治療為根除結核病的重要策略。本研究為比較潛伏結核感染治療中,3個月Isoniazid與Rifapentine短程治療處方(簡稱3HP)及9個月Isoniazid治療處方(簡稱9H)之完治率,並探討行動線索:都治關懷,以及行動障礙:副作用發生情形對於完治率之影響。本研究採用衛生福利部傳染病監測系統疫情資料倉儲(BO)之結核病接觸者管理資料,經選取臺北市2016年1月至2017年9月之潛伏結核感染個案之治療紀錄進行分析。
    研究分析之個案共373人,97.9%加入都治方案,完治率達89.8%。其中317人接受3HP治療者,6.9%有發生副作用,89.3%完成治療;另56人接受9H治療處方者,僅1.8%發生副作用,92.8%完成治療,9H治療組之完治率高於3HP組,但沒有顯著不同。治療期間無發生副作用者的完治率,顯著高於有發生副作用者。9H治療組中,遠端都治個案的完治率95%,高於傳統都治個案之完治率89.3%,但無顯著差異。年齡為完成治療的預測因子,每增加1歲其完治的機率減少5%。建議持續推廣3HP短程的治療處方合併都治關懷治療潛伏結核感染者,並將遠端都治納入3HP都治關懷的服務選項,以強化高風險族群接受預防性治療的意願,使有效降低結核病發生之風險。

    Treatment of latent tuberculosis infection (LTBI) is an important strategy toward TB elimination. The study was to evaluate the completion rate of 3 months of isoniazide and rifapentine regimen (3HP) and compared to 9 months of isoniazid regimen (9H). A retrospective data base study was employed to analyze the treatment of LTBI data from 2016 Jan to 2017 Sep in Taipei city from Business Objects (BO) system of Taiwan Centers for Disease Control (Taiwan CDC). Using Cox proportional hazards regression to examine the correlation of cues to action, DOPT, barriers of action, and side effect to the completion rate for latent tuberculosis infection treatment.
    The total sample cases included in this study was 374, while 97.9% of the cases joined DOPT and had a completion rate of 89.8%. The 3HP regimens included 317 cases. 6.9% of them had side effects and the completion rate was 89.3%. The 9HP regimens had 56 cases. 1.8% of them had side effects and the completion rate was 92.8%. The completion rate for cases without side effects were significantly higher than those with side effects. Cases in 9HP regimens using telecare DOPT had 95% of completion rate while the regular DOPT hold a 89.3% completion rate. Age is the major predictor of completion rate. Completion rate decreases 5% for every one year increase of age. The 3HP regimens for DOPT with telecare is recomanded to elevate the acceptence of preventive treatment for LTBI.

    致謝 I 中文摘要 II 英文摘要 III 目次 IV 表目次 VII 圖目次 VIII 第一章 緒論 1 第一節 研究動機與重要性 1 第二節 研究目的 3 第三節 研究問題 4 第四節 研究假設 5 第五節 名詞界定 6 第六節 研究限制 8 第二章 文獻探討 9 第一節 國內外之結核病流行現況 9 第二節 潛伏結核感染治療 12 第三節 影響潛伏結核感染治療完治率之相關因素 31 第四節 健康信念模式及其應用 33 第三章 研究方法 35 第一節 研究架構 35 第二節 研究對象 36 第三節 研究內容 37 第四節 研究資料 42 第五節 資料處理 44 第六節 研究倫理 46 第四章 研究結果與討論 47 第一節 研究對象各變項之描述性分析 47 第二節 兩組治療處方之各變項差異情形 51 第三節 各類變項之完治率差異分析 55 第四節 完治率之預測因子 58 第五節 討論 59 第五章 結論與建議 61 第一節 結論 61 第二節 建議 62 參考文獻 64 附錄一 研究分析個案篩選流程 69 附錄二 資料庫所提供研究相關變項清單 70

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