Rural poverty and delayed presentation to tuberculosis services in Ethiopia
Rural poverty and delayed presentation to tuberculosis services in Ethiopia
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DOI：
10.1111/j.1365-3156.2005.01393.x
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发表时间：
2005-04-01
影响因子：
3.3
通讯作者：
Cuevas, LE
中科院分区：
文献类型：
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作者：
Cambanis, A;Yassin, MA;Cuevas, LE
为了衡量首次就诊的时间并评估影响就医决定的因素，我们在埃塞俄比亚阿瓦萨附近的一家农村卫生中心采访了243名接受痰检查以诊断结核病(TB)的患者。使用的是结构化问卷。患者平均延迟4.3(9.8±12.4)周。超过4周的延误与农村居住、交通时间超过2小时、通宵旅行、交通费用超过1.40美元、在访问前出售个人资产以及使用传统药物有关。当被直接问及延误的原因时，大多数患者提到了医疗保健的经济或后勤障碍。结核病病例发现战略必须对患者延误敏感，农村地区的卫生系统必须变得更容易获得。
To measure time to initial presentation and assess factors influencing the decision to seek medical attention, we interviewed 243 patients undergoing sputum examination for the diagnosis of tuberculosis (TB) at a rural health centre near Awassa, Ethiopia. A structured questionnaire was used. Median (mean + SD) patient delay was 4.3 (9.8 + 12.4) weeks. Delays over 4 weeks were significantly associated with rural residence, transport time over 2 h, overnight travel, transport cost exceeding US$1.40, having sold personal assets prior to the visit, and use of traditional medicine. The majority of patients cited economic or logistical barriers to health care when asked directly about causes of delay. Case-finding strategies for TB must be sensitive to patient delay and health systems must become more accessible in rural areas.