Evaluated effectiveness of tuberculosis care policy in Taiwan：Management and control free second-line anti-tuberculosis drug, 2008-2011.

• Main Authors: Wen-Ting Kuo, 郭玟婷
• Other Authors: 陳端容
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/kw9c93

碩士 === 國立臺灣大學 === 公共衛生碩士學位學程 === 101 === Research purpose In 2006, Taiwan Center for Disease Control commissioned Chest hospital, department of health to implement one of the TB control strategies: free second-line anti-tuberculosis drugs management and sending plan. The plan connects one of DOTS elements, uninterrupted supply of quality-assured drugs, which uses free drugs to be an intervention in Taiwan TB control policy. It has been executed in many years, the Government consumed lots of personnel, material and funds, but the relative between this plan and domestic TB treatment is still unknown. In this study, we will investigate the effectiveness of the plan. Method For the sake of consisting with the background of police implementation, data is collected from 2008 to 2011. In this study, cases are divided into three groups: MDR-TB, drug-resistant but not MDR-TB, and side-effects, and then logged in TB notification system to confirm all case information. When sending free second-line drugs as an anti-TB strategy intervention, descriptive statistical analysis and statistical software SAS 9.2 are used to observe demographic variables. In the last, chi-square test and logistic regression statistical analysis would be used to evaluate effectiveness. Result By the chi-square test, age (P <0.0001), gender (P = 0.0003) and apply medication reasons (P = 0.0009) are statistical significance; application medication annual (P = 0.26) and the application of medication area (P = 0.32), and whether the city and the county (P = 0.23) are not statistically significant. Then, logistic regression analysis revealed that age, sex and apply medication reasons of statistical significance when outcome is treatment complete. In age part, more than 65 years group as the reference, the odds ratio of below 20 years is 5.27(OR=5.27, 95%CI 0.69-40.43), 21years to 34years is 13.6(OR=13.6, 95%CI 4.26-43.36) ,35 years to 49 years is 3.78(OR=3.78, 95%CI 2.5-5.72), 50 years to 64years is 2.44(OR=2.44, 95%CI 1.88-3.18).The whole treatment complete is better than above 65 years group. In sex part, male as the reference group, treatment complete rate of female is 1.48(OR=1.48, 95%CI 1.17-1.87). In apply medication reasons part, side-effects as the reference, the odds ratio of MDR-TB is 0.96(OR=0.96, 95%CI 0.56-1.64); drug-resistant but not MDR is 1.53 (OR=1.53, 95%CI 1.16-2.01). The drug-resistant but not MDR group is better than others. Conclusions According to statistical analysis, it shows that the free second-line anti-tuberculosis drugs strategy is effective for TB control. WHO repeatedly appeals the DOTS strategy must be fully implemented to make achieve effectiveness. However, some cases only apply for free medication without adding DOTS in this study. Therefore, how to fully implement DOTS and DOTS comprehensive coverage of all TB patients in Taiwan, is a big challenge for future prevention.