Patients' Delay in Seeking Health Care for Tuberculosis Diagnosis in East Gojjam Zone, Northwest Ethiopia
Patients' Delay in Seeking Health Care for Tuberculosis Diagnosis in East Gojjam Zone, Northwest Ethiopia
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DOI：
10.4269/ajtmh.16-0892
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发表时间：
2017-01-01
影响因子：
3.3
通讯作者：
Weldu, Yemane
中科院分区：
文献类型：
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作者：
Asres, Mihret;Gedefaw, Molla;Weldu, Yemane
结核病患者就诊延误是结核病管理中的一个主要问题。相对于结核病的负担，在埃塞俄比亚，缺乏关于求医延误程度的数据，也缺乏关于患者未能在卫生设施寻求早期护理的原因的数据。2013年4月至7月在埃塞俄比亚阿姆哈拉东戈贾姆区进行了一项基于设施的横断面研究，以评估结核病患者的延误和相关因素。采用简单随机抽样方法，招募了605名参与者（327名男性和278名女性）。其中，323名（53.4%）结核病患者延迟就医（中位数= 45天;平均= 78.5天）。以下独立变量与患者延迟相关：年龄≥ 45岁（调整后的比值比[AOR] = 8.74，95%置信区间[CI] = 4.71-16.23，P < 0.001）;农民（AOR = 4.18，95% CI = 1.44-12.11，P = 0.009）;之前访问过圣水点、传统治疗师和/或私人药店（AOR = 69.11，95% CI = 13.91-343.29，P < 0.001; AOR = 14.74，95% CI = 1.43-152.31，P = 0.024; AOR = 2.10，95% CI = 1.22-3.59，P = 0.007）;对结核病知识了解不足（AOR = 2.79，95% CI = 1.74-4.92，P = 0.006），对肺外结核病知识了解不足（AOR = 14.69，95% CI = 8.21-26.26，P < 0.001）。一般来说，病人在医疗机构就医的延误率很高（53.4%）。接受圣水治疗的结核病患者（95.3%; 101/106）和接受传统治疗的结核病患者（84.6%; 11/13）的治疗延迟。因此，为了早期寻求现代卫生保健，需要采取综合干预措施来鼓励结核病患者。
Patients' delay in seeking diagnosis is a major problem in the management of tuberculosis (TB). Relative to the burden of TB, there is lack of data on the magnitude of delays in seeking care and why patients fail to seek early care at health facilities in Ethiopia. A facility-based cross-sectional study was conducted from April to July 2013 in East Gojjam Zone, Amhara, Ethiopia, to assess patients' delays and associated factors in TB patients. Using simple random sampling, 605 (327 male and 278 female) participants were recruited. Of the total, 323 (53.4%) TB patients were delayed in seeking health care (median = 45 days; mean = 78.5 days). The following independent variables were associated with patient delays: age >= 45 years (adjusted odds ratio [AOR] = 8.74, 95% confidence interval [CI] = 4.71-16.23, P < 0.001); working as a farmer (AOR = 4.18, 95% CI = 1.44-12.11, P = 0.009); prior visit to holy water sites, traditional healers, and/or private drug shops (AOR = 69.11, 95% CI = 13.91-343.29, P < 0.001; AOR = 14.74, 95% CI = 1.43-152.31, P = 0.024; AOR = 2.10, 95% CI = 1.22-3.59, P = 0.007, respectively); poor knowledge about TB (AOR = 2.79, 95% CI = 1.74-4.92, P = 0.006), and extrapulmonary TB (AOR = 14.69, 95% CI = 8.21-26.26, P < 0.001). Generally, patients' delay in seeking care at health facilities was high (53.4%). Most of TB patients getting treatment from holy water (95.3%; 101/106) and traditional healers (84.6%; 11/13) were delayed. Therefore, for early seeking in modern health care, a combination of interventions is required to encourage TB patients.