Gender differences in delays in diagnosis and treatment of tuberculosis
Gender differences in delays in diagnosis and treatment of tuberculosis
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DOI：
10.1093/heapol/czm026
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发表时间：
2007-09-01
影响因子：
3.2
通讯作者：
Diwan, Vinod K.
中科院分区：
文献类型：
--
作者：
Karim, Fazlul;Islam, Md. Akramul;Diwan, Vinod K.
目的 评估症状出现延迟方面的性别差异，以帮助在孟加拉国 10 个分区的 250 万人中使用 DOTS 在社区层面寻找、诊断和治疗结核病 (TB)，这是一个非政府组织（跨社区建设资源，或 BRAC）的结核病控制 DOTS 计划。设计对 1000 名新诊断的肺结核患者（500 名女性和 500 名男性）进行横断面调查。结果与男性相比，总延迟（分别为 63.2 和 61.0 天 vs. 60.3 和 53 天）、总诊断延迟（61.2、60.0 天 vs. 58.5、52.0 天）、患者延迟（51.9、50.0 天 vs. 48.7、42.0 天）和治疗延迟（2.0、1.0 天）的平均延迟和中位延迟明显更长与 1.9、1.0 天相比）。患者的平均延误时间和中位数延误时间比卫生系统的延误时间长。然而，患者性别与总延误、总诊断延误和患者延误有很强的相关性。女性年龄较大分别与较长的患者和治疗延迟类别显着相关。 结论 与男性相比，女性在寻求结核病治疗的临床过程的各个阶段经历了较长的延迟。这就需要采取适当的措施来改善这种情况。
Objective To assess the gender variations in delay from symptom onset to help seeking, diagnosis and treatment of tuberculosis (TB) using DOTS at community level, in 10 subdistricts of Bangladesh with 2.5 million people under a non-governmental organization's (Building Resources Across Communities, or BRAC) DOTS programme for TB control.Design A cross-sectional survey of 1000 newly diagnosed pulmonary TB patients (500 women and 500 men).Findings Women, in comparison with men, had significantly longer mean and median delays in total delay (63.2 and 61.0 days vs. 60.3 and 53 days, respectively), total diagnostic delay (61.2, 60.0 vs. 58.5, 52.0 days), patient's delay ( 51.9, 50.0 vs. 48.7, 42.0 days) and treatment delay (2.0, 1.0 vs. 1.9, 1.0 day). Patient's mean and median delays were longer than the health system delay. However, patient gender showed strong association with total delay, total diagnostic delay and patient's delay. Older age of women was significantly associated with longer patient and treatment delay categories, respectively.Conclusion Compared with men, women experienced longer delays at various stages of the clinical process of help seeking for TB. This warrants appropriate measures to improve the situation.