頁籤選單縮合
題 名 | 臺灣2015年2月至4月抗藥性肺結核病人發現情形=Drug Resistant Tuberculosis among Tuberculosis Patients and Their Referral Rates |
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作 者 | 劉璟函; 鄭憶雯; 朱柏威; 王貴鳳; 周如文; 黃彥芳; 陳昶勳; 詹珮君; 陳昶勳; 劉璟函; 周如文; 黃彥芳; 朱柏威; 詹珮君; 王貴鳳; 鄭憶雯; | 書刊名 | 疫情報導 |
卷 期 | 32:12 2016.06.21[民105.06.21] |
頁 次 | 頁250-258 |
分類號 | 412.452 |
關鍵詞 | 抗藥性結核病; 多重抗藥性結核病醫療照護體系; 抗藥性分子檢測; TMTC; |
語 文 | 中文(Chinese) |
中文摘要 | 世界衛生組織早在1999年提出加強型都治,希望能妥善治療多重抗藥性結核病(MDR-TB),減少社區傳播。2006年,世界衛生組織再次警告,指出「抗藥性肺結核蔓延」是一個威脅全球的重大公衛問題。 我國於2007年5月成立「多重抗藥性結核病醫療照護體系」(Taiwan Multidrug Resistant Tuberculosis Consortium, TMTC),由五個結核病專業醫療照護團隊,收治抗藥性結核病患,並訓練關懷員執行社區進階都治工作,給予病患專業完整之照護,執行成效顯著。及時找出抗藥性結核病患,可增進收治至TMTC接受治療的效率。故本研究主要目的為瞭解我國目前抗藥性結核病患發現之情形。 本研究的對象為中央傳染病追蹤管理系統中,建檔日期或重開日期於2015年2月1日至4月30日期間,2739位通報肺結核病患。其中0.5% (15/2739)沒有培養紀錄可查,培養陽性病人中,98.5% (2112/2145)具有完整的藥物敏感性測試結果。抗藥結果顯示,37人(1.7%)對rifampicin抗藥(其中26人為多重抗藥性),3人(0.1%)為任三種抗藥。推估肺結核病患中,實際rifampicin抗藥發生率為1.4%,多重抗藥性為1.0%。符合納入TMTC團隊條件的病患數總計31人,實際納入數為23人(74.2%)。尚未納入團隊的8人中,MDR有2人(25%)、RR有5人(62.5%)、任三種抗藥則有1人(12.5%)。 由此研究結果可知,抗藥性結核病人之發現已趨完整。若未來能持續利用新診斷工具慎選族群使用,縮短抗藥性結核病患的偵測,預期能進而縮短轉介至TMTC的時間,幫助臺灣減少抗藥性結核病的傳播。 |
英文摘要 | The World Health Organization (WHO) proposed a DOTS-plus (Directly Observed Therapy Strategies-plus) policy in 1999, in the hopes of treating multi-drug resistant TB (MDR-TB) properly and reducing the transmission of MDR-TB within communities. In 2006, the WHO stated that extensive drug-resistant tuberculosis (XDR-TB) is a serious threat to public health globally. The Taiwan Multidrug-resistant TB Consortium (TMTC) was established in May 2007. TMTC is composed of five professional medical care teams responsible for treating MDR-TB patients; it trains designated DOTS workers to provide comprehensive and professional DOTS-plus service in communities. Earlier detection of MDR-TB patients makes the referring process to TMTC more efficient. The purpose of this study is to calculate case finding and referral rates for MDR-TB patients enrolled with the TMTC. For pulmonary TB patients who (1) registered as new or relapsed in the National TB Registry between February 2015–April 2015; and (2) had a culture-proven diagnosis, 98.5% had drug susceptibility test (DST) results. Of the 2122 patients with DST results, 37 patients (1.7%) were with rifampicin resistance, and 3 patients (0.1%) were with three or more anti-TB drugs resistance. Among 31 MDR-TB patients who met TMTC enrollment criteria, 23 (74.2 %) were referred. Patients not being referred to TMTC included 2 with MDR-TB (25%, 2/8), 5 with RR-TB (62.5%, 5/8), and 1 with three or more drug-resistant TB (12.5%, 1/8). |
本系統中英文摘要資訊取自各篇刊載內容。