.: ORİJİNAL ARAŞTIRMA
The Treatment of Latent Tuberculosis Infection: Province Based Practice and Problems
Latent Tüberküloz Enfeksiyonu Tedavisi: İl Bazlı Uygulamalar ve Sorunlar
Turkiye Klinikleri J Med Sci. 2020;40(3):358-65
doi: 10.5336/medsci.2020-74753
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: To investigate the treatment indications and compliance of individuals who underwent preventive treatment for latent tuberculosis infection (LTBI) in Turkey at the provincial level. Material and Methods: The data were collected retrospectively from records of 1,147 tuberculosis (TB) patients who have been followed-up in Elazığ TB Dispensary between the years 2005 and 2013. Results: Preventive treatment of LTBI was applied to 1,264 registered individuals for the indication of various factors. The causative factors for initiating preventive therapy were the history of contact with TB patients (55.1%), immunosuppression (28.2%), tuberculin skin test (TST) positivity (8.2%), TST conversion (0.1%) and for other reasons (8.4%). Of the patients, 66.3% had completed preventive treatment with success, however, 33.4% have abandoned their therapies. All of the patients have used isoniazid as preventive drug treatment. Conclusion: Preventive treatment for LTBI was applied most frequently with the indication of contact history with TB and the second indication was immunocompromised patients either by getting the drug or having a disease that is susceptible to TB infection. Unfortunately, the results of the study suggested that rates of completed treatment were not high enough.
Keywords: Latent tuberculosis; prevention and control
Objective: To investigate the treatment indications and compliance of individuals who underwent preventive treatment for latent tuberculosis infection (LTBI) in Turkey at the provincial level. Material and Methods: The data were collected retrospectively from records of 1,147 tuberculosis (TB) patients who have been followed-up in Elazığ TB Dispensary between the years 2005 and 2013. Results: Preventive treatment of LTBI was applied to 1,264 registered individuals for the indication of various factors. The causative factors for initiating preventive therapy were the history of contact with TB patients (55.1%), immunosuppression (28.2%), tuberculin skin test (TST) positivity (8.2%), TST conversion (0.1%) and for other reasons (8.4%). Of the patients, 66.3% had completed preventive treatment with success, however, 33.4% have abandoned their therapies. All of the patients have used isoniazid as preventive drug treatment. Conclusion: Preventive treatment for LTBI was applied most frequently with the indication of contact history with TB and the second indication was immunocompromised patients either by getting the drug or having a disease that is susceptible to TB infection. Unfortunately, the results of the study suggested that rates of completed treatment were not high enough.
Keywords: Latent tuberculosis; prevention and control
ÖZET
Amaç: Türkiye'de latent tüberküloz enfeksiyonu (LTE) için önleyici tedavi gören bireylerin il düzeyinde tedavi endikasyonlarını ve uyumlarını araştırmak. Gereç ve Yöntemler: Elazığ Verem Savaşı Dispanseri'nde 2005-2013 yılları arasında kayıtlı koruyucu ilaç tedavisi alanlara ait veriler dosyalardan kaydedilmiştir. Bulgular: LTE için koruyucu tedavi, farklı endikasyonlarda 1.264 kişiye uygulanmıştır. Koruyucu tedavi alan bireylerin %55,1'ine tüberküloz hastası ile temas öyküsü, %28,2'sine (n=357) bağışıklığın baskılanması, %8,2'sine tüberkülin deri testi (TDT) pozitifliği, %0,1'ine TDT konversiyonu, %8,4'üne ise diğer nedenlerle koruyucu ilaç tedavisi başlanmıştır. Koruyucu tedavi alan bireylerin %66,3'ünün tedavileri tamamlanmış, %33,4'ü ise koruyucu ilaç tedavisini terk etmiştir. Koruyucu ilaç tedavisinde bireylerin tamamı izoniyazid kullanmıştır. Sonuç: Koruyucu ilaç tedavisi alan bireylerin çoğunluğunu tüberküloz hastası ile temas öyküsü olanlar oluştururken; ikinci sırada ise gerek ilaç kullanımı gerekse bir hastalık nedeni ile tüberküloza yatkınlık gösteren bağışıklığı baskılanmış bireyler yer almaktadır. Çalışmamızın sonuçlarına göre tedaviyi tamamlama oranları yeterince yüksek değildir.
Anahtar Kelimeler: Latent tüberküloz; önleme ve kontrol
Amaç: Türkiye'de latent tüberküloz enfeksiyonu (LTE) için önleyici tedavi gören bireylerin il düzeyinde tedavi endikasyonlarını ve uyumlarını araştırmak. Gereç ve Yöntemler: Elazığ Verem Savaşı Dispanseri'nde 2005-2013 yılları arasında kayıtlı koruyucu ilaç tedavisi alanlara ait veriler dosyalardan kaydedilmiştir. Bulgular: LTE için koruyucu tedavi, farklı endikasyonlarda 1.264 kişiye uygulanmıştır. Koruyucu tedavi alan bireylerin %55,1'ine tüberküloz hastası ile temas öyküsü, %28,2'sine (n=357) bağışıklığın baskılanması, %8,2'sine tüberkülin deri testi (TDT) pozitifliği, %0,1'ine TDT konversiyonu, %8,4'üne ise diğer nedenlerle koruyucu ilaç tedavisi başlanmıştır. Koruyucu tedavi alan bireylerin %66,3'ünün tedavileri tamamlanmış, %33,4'ü ise koruyucu ilaç tedavisini terk etmiştir. Koruyucu ilaç tedavisinde bireylerin tamamı izoniyazid kullanmıştır. Sonuç: Koruyucu ilaç tedavisi alan bireylerin çoğunluğunu tüberküloz hastası ile temas öyküsü olanlar oluştururken; ikinci sırada ise gerek ilaç kullanımı gerekse bir hastalık nedeni ile tüberküloza yatkınlık gösteren bağışıklığı baskılanmış bireyler yer almaktadır. Çalışmamızın sonuçlarına göre tedaviyi tamamlama oranları yeterince yüksek değildir.
Anahtar Kelimeler: Latent tüberküloz; önleme ve kontrol
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