Factors affecting delays in tuberculosis diagnosis in rural China: a case study in four counties in Shandong Province
Factors affecting delays in tuberculosis diagnosis in rural China: a case study in four counties in Shandong Province
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DOI：
10.1016/j.trstmh.2004.07.005
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发表时间：
2005-05-01
影响因子：
2.2
通讯作者：
Tang, S
中科院分区：
文献类型：
--
作者：
Cheng, G;Tolhurst, R;Tang, S
提高病例发现率是中国结核病控制工作面临的紧迫而严峻的挑战。我们调查了结核病患者延迟寻求结核病护理和健康服务延迟诊断的程度，以及与延迟相关的社会经济因素。2001年，对山东省4个县的190名新发涂阳肺结核患者进行了标准问卷调查。COX回归的多因素分析显示，高龄、受教育程度和离家到乡镇卫生院的距离与延迟寻求服务提供者的时间显著相关。在检查第一次接触服务提供者和诊断之间的延迟时，我们发现女性经历的延迟比男性更长，而且延迟程度越高。第一次就诊的设施患者，实现诊断所需的时间越少。在多因素COX回归分析中，这两个因素具有统计学意义。我们得出的结论是，老年人、受教育程度较低的人、妇女和居住在远离卫生设施的人在获得结核病服务和获得诊断方面面临最长的延误。(C)2004年皇家热带医学和卫生学会。爱思唯尔有限公司出版。保留所有权利。
Improving case detection is an urgent and serious challenge for tuberculosis (TB) control in China. We investigated the extent to which TB patients delayed seeking TB care and health services delayed reaching a diagnosis, and socioeconomic factors associated with the delays. Standard questionnaires were administered to 190 new smear-positive TB patients who had completed treatment at TB dispensaries in four counties of Shandong Province in 2001. Multivariate analysis using Cox Regression showed that old age, tack of education and distance from home to a township health centre were significantly associated with delay in seeking care from service providers. In examining the delay between first contact with a service provider and diagnosis, we found that women experienced Longer delays than men, and that the higher the Level. of facility patients first visited, the Less time was needed to achieve a diagnosis. These two factors were statistically significant in multivariate Cox Regression analysis. We concluded that the elderly, the less educated, women, and those living far from health facilities face the Longest delays in reaching TB services and achieving diagnosis. (c) 2004 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.