The Effects And Influence Factors Of DOTS Strategy In Pulmonary Tuberculosis

Objective:To analyze the effects of DOTS strategy and to evaluate the current prognosis and management situation among pulmonary tuberculosis patients by utilizing DOTS strategy in Linyi from 2010 to 2014.To find out the most critical influences of DOTS strategy and to improve and perfect DOTS strategy for effectively controlling pulmonary tuberculosis and providing scientific basis.Methods:The current prognosis and management situation among patients with pulmonary tuberculosis by utilizing DOTS strategy was carried out through descriptive analysis. Totally 287 cases(patients with pulmonary tuberculosis and who utilized DOTS strategy) were enrolled in this study. Follow-up data involved patients’ demographic data,smoking,alcohol consumption,nutritional status,blood glucose control,the results of the patient treatment and the patient has been cured of drug leakage,interruption of treatment,management,timely review and other management related indicators. The influences of DOTS strategy would be analyzed by multi-factor logistic regression analysis.Results:The reported incidence of tuberculosis declined in Linyi, the new smear positive five-year average cure rate was 94.59%. The cure rate of pulmonary tuberculosis was 86.41%. The proportion of patients had missing medication was 18.37%,the proportion of treatment interruption was 9.89%,the ratio of fails to review was 16.61%.The risk ratio of still smoking, drinking after leave hospital was 2.97,2.31 fold compared with no smoking,no drinking patients.The risk ratio of cavity was 1.26 fold compared with no cavity patients. The risk ratio of moderate, severe malnutrition in patients was 1.07, 1.27, 5.59 fold compared with normal nutritional patients.The risk ratio of glycemic control in general, patients with poor control was 1.15, 3.27 fold compared with good glycemic control in patients.The risk ratio of patients unsupervised medication was 2.37, 1.52 fold compared with supervised patients of missing medication and treatment interruption.The risk ratio of social stigma was 1.68,1.23,1.43 fold compared with no social stigma of missing medication, treatment interruption and failure to review.The risk ratio of denied treatment course was 2.43, 2.79, 11.07 fold compared with believe treatment course of missing medication, treatment interruption and failure to review. The main reason of missing medication, treatment interruption were adverse drug reactions,accounting for 73.08%,46.43%,respectively.The main reason of patients fails to review were feeled sicker,no need to check(40.43%).Conclusion and suggestion : DOTS strategy was perfect system for the treatment of pulmonary tuberculosis, because it improved tuberculosis treatment completion rates and clinical cure rates. The influences of DOTS strategy involved the age, residence, lesion whether had empty, smoking, alcohol consumption,nutritional status and glycemic control.whether the patient being supervised medication, social stigma and patient recognition to the course of treatment were the factors which effected missing medication and treatment interruption. Recommended at the same time DOTS strategy treatment, the patients with diabetes to control blood sugar and professional nutrition guidance.Comprehensive prevention and control the patients with complications.Encourage community and family giving care for petients,urge patients to overcome bad habits,enhance patients’ confidence,eliminating social stigma,promote their cure rate and improve the patients’ quality of life.