关键词: 活动性肺结核, 家庭密切接触者, 预防性治疗, 服药依从性

Abstract: Objective To investigate the status of and factors associated with preventive therapy adherence among household close contacts of patients with active pulmonary tuberculosis. Methods A stratified cluster random sampling method was employed to select household close contacts of patients with active pulmonary tuberculosis admitted to the Affiliated Hospital of Inner Mongolia Medical University between March 2022 and January 2025. A questionnaire was administered to collect data on demographic characteristics, reception of health education, and knowledge of tuberculosis. The Hospital Anxiety and Depression Scale (HADS) was utilized to assess anxiety and depression, the Adult Health Self-Management Ability Scale was used to evaluate self-management skills, and the Morisky Medication Adherence Scale was employed to measure adherence to preventive therapy. A multivariate logistic regression analysis was conducted to identify the influencing factors of preventive therapy adherence. Results A total of 236 household close contacts of patients with active pulmonary tuberculosis were included in this study. Among them, 62 individuals exhibited insufficient adherence to preventive therapy (Morisky Medication Adherence Scale score <6), while 174 demonstrated good adherence (Morisky Medication Adherence Scale score ≥6). The proportion of individuals with an education level of junior high school or below, a history of BCG vaccination, an annual household income of less than 50 000 yuan, anxiety or depression, no reception of health education, and a lack of tuberculosis knowledge was significantly higher in the group with insufficient adherence compared to the group with good adherence. Furthermore, self-management ability was lower in the insufficient adherence group (all P<0.05). The logistic regression analysis revealed that an education level of junior high school or below (OR=4.792), not receiving health education (OR=3.307), and the presence of anxiety or depression (OR=4.679) were risk factors for insufficient adherence to preventive therapy among household close contacts. Conversely, self-management ability (OR=0.230) was identified as a protective factor for adherence (all P<0.05). Conclusion A notable proportion of household close contacts of patients with active pulmonary tuberculosis demonstrates insufficient adherence to preventive therapy. Adherence is significantly associated with educational level, the presence of anxiety or depression, reception of health education, and self-management ability.

Key words: Active pulmonary tuberculosis, Household close contacts, Preventive therapy, Medication adherence