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首页> 外文期刊>Patient Preference and Adherence >Text messaging to decrease tuberculosis treatment attrition in TB-HIV coinfection in Uganda
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Text messaging to decrease tuberculosis treatment attrition in TB-HIV coinfection in Uganda

机译：短信在乌干达减少结核病/艾滋病毒合并感染中的肺结核治疗损耗

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Background: Low tuberculosis (TB) treatment completion rates in sub-Saharan Africa are an important driver of multidrug resistance. Mobile technology-based interventions have been shown to improve adherence to antiretroviral therapy in sub-Saharan Africa. We aimed to test the effect of a short-message service (SMS) intervention on loss to follow-up (LFU). Materials and methods: In this quasi-experimental study, all adult, literate, HIV-infected patients with mobile phone access diagnosed with TB between November 2010 and October?2011 in an urban clinic in Uganda were eligible to receive adherence and appointment reminders and educational quizzes during the first 8 weeks of TB treatment. Their risk of LFU in the first 8?weeks of treatment was compared with that of patients starting treatment between March 2009 and August 2010 using logistic regression. Results: One of 183 (0.5%) enrolled patients was lost to FU during the intervention compared to six of 302 (2.0%) in the preintervention control group (RR 0.27, 95% CI 0.03–2.07; P =0.22). The SMS intervention was rated as very helpful by 96%. Barriers identified included interrupted phone access (26%, median 14 days) and difficulties responding by SMS. The response rate to educational quizzes was below 10%. There were no unintentional disclosures of TB or HIV status due to the intervention. Conclusion: An SMS reminder service did not show a clear effect on short-term risk of LFU in this study, which was underpowered due to a lower baseline risk in the control group than expected. The SMS-reminder service was rated highly, and there were no breaches of confidentiality. Important technological barriers have implications for larger-scale implementation, not only for TB but also other disease modalities.
机译：背景：撒哈拉以南非洲地区结核病（TB）的低治疗完成率是多重耐药性的重要推动力。在撒哈拉以南非洲地区，基于移动技术的干预措施被证明可以提高对抗逆转录病毒疗法的依从性。我们旨在测试短消息服务（SMS）干预对失访的影响（LFU）。材料和方法：在这项准实验研究中，所有在2010年11月至2011年10月至2011年10月至2011年10月在乌干达城市诊所被诊断出患有结核病的成人，识字，感染了HIV的移动电话患者都有资格接受依从性和约会提醒和教育结核病治疗的前8周进行测验。使用logistic回归比较了他们在治疗的前8周中LFU的风险与在2009年3月至2010年8月开始治疗的患者的LFU风险。结果：干预期间，入组的183名患者中有1名（0.5％）丢失了FU，而干预前对照组的302名中有6名（2.0％）（RR 0.27，95％CI 0.03–2.07; P = 0.22）。 SMS干预被评为96％非常有帮助。确定的障碍包括电话访问中断（中位数14天，占26％）和SMS响应困难。教育测验的回应率低于10％。由于干预，没有意外披露结核病或艾滋病毒状况。结论：在这项研究中，SMS提醒服务并未对LFU的短期风险显示明显的效果，但由于对照组的基线风险低于预期，因此该功能不足。 SMS提醒服务获得了很高的评价，并且没有违反保密性。重要的技术壁垒不仅对结核病，而且对其他疾病模式，都对大规模实施产生影响。

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