計畫名稱：結核病病患都治計畫治療效益評估與影響因素探討-以監獄 結核病患為例
96-2314-B-468-001- 研究計畫英文摘要：
Key words: DOTS; Tuberculosis; Tuberculosis patients; Prisoner; Prison In 1995, World Health Organization (WHO) pointed out that tuberculosis (TB) was ranked the second leading infectious diseases in the world. According to the statistics of 2006 from Taiwan CDC, the incidence and death rate of TB was 72.47 and 4.27 per hundred thousand population in 2005, respectively. These rates were still much higher than TB controlled standard defined by WHO: “TB death rate is less than 2 per hundred thousand population”. Moreover,
tuberculosis was ranked the thirteen leading causes of death in Taiwan. In prisons, the probability of TB inter-infection is much higher due to the high- density population. The incidence of TB in prisons was 0.24%, which was much higher than that (0.07%) of general population in 2005. TB prevention and treatment still needs to be improved continuously in the prisons.
After the Directly Observed Treatment, Short Schedule (DOTS) was executed in different countries in recent years, the incidence and death rate decreased obviously. DOTS programs and chest x-ray screens have been executed for several years in Taiwan. However, there was no related research to completely investigate the effectiveness of DOTS programs on prison’s TB patients and to survey the medical staff. This research would like to examine DOTS-TB
treatment effectiveness on TB prisoners and the evaluation of DOTS programs by medical staff in the prisons.
This research will use structured questionnaire to investigate TB prisoners participating in DOTS programs to collect the information such as personal characteristics, treatment status, health condition, TB perception, and health care satisfaction. In addition, the semi-structured questionnaire and deep interview will
be applied to the medical staff in prisons to understand their perception of DOTS program, the difficulties of their work, and their opinions on DOTS
programs. At the same time, this research will apply CDC dataset to analyze the death rate, complete treatment rate, default rate, days of complete treatment, and the rate of multidrug-resistant tuberculosis (MDR-TB) for DOTS-TB prisoners.
This research will use descriptive statistics to understand the distributions of all related variables for DOTS-TB prisoners. Chi-square test and t-test will apply to test the significant difference between DOTS-TB prisoners with complete
treatment and without complete treatment. Multivariate logistic regression will be used to analyze the significant factors that influence the treatment outcome for DOTS-TB prisoners. Multiple regression analysis will be applied to investigate the factors that influence the duration of treatment.
This result will be compared with the results of another subproject:
“Effectiveness of DOTS program for TB patients living in communities”. Two sample t-test will be applied to test whether the average duration of treatment is
significantly different between DOTS-TB prisoners and DOTS-TB patients living in communities. Moreover, chi-square test will be used to test the difference of complete treatment rate between these two groups. Finally, this research will compare and integrate with the results of all other subprojects.
According to these comprehensive results about the effectiveness of DOTS programs, this research will propose the recommendations for DOTS program in prison as the reference for further health policy decision.
