Martin Allison, Baptiste Jeanne Pierre, Krieger Gary
BP, Tillies, Munstead Health Road, Godalming, Surrey GU8 4AR, UK.
Clin Occup Environ Med. 2004 Feb;4(1):189-204. doi: 10.1016/j.coem.2003.10.006.
Positive-microscopy TB is a real issue for the respiratory diseases department of N'Djaména General Hospital, with a prevalence rate of 37 cases in 100 patients. The delay of diagnosis for positive-microscopy TB is excessive. Patients seem to be more responsible for this delay than the healthcare facilities. The factors that delay treatment of TB in N'Djaména are that (1) TB diagnosis in peripheral hospitals lengthens physician delay, and (2) seeking initial treatment outside conventional medicine lengthens patient delay. The following recommendations arise from this study: For the public health ministry: Reboost the national program against TB in Chad. Increase personnel in the respiratory diseases department at the N'Djaména General Hospital. Provide refresher TB education to care providers, stressing the importance of communication with the patient. For the national program against TB in Chad: Initiate a public information, education, and communication campaign about TB. Implement use of DOTS nationwide. For physicians increase communication with patients.
痰涂片阳性结核病是恩贾梅纳综合医院呼吸科面临的一个实际问题，患病率为每100名患者中有37例。痰涂片阳性结核病的诊断延迟过长。患者似乎比医疗机构对这种延迟负有更大责任。在恩贾梅纳，导致结核病治疗延迟的因素有：（1）外围医院的结核病诊断延长了医生的延迟时间，（2）在传统医学之外寻求初始治疗延长了患者的延迟时间。本研究提出了以下建议： 对于公共卫生部：在乍得重新推动国家结核病防治计划。增加恩贾梅纳综合医院呼吸科的人员。为医护人员提供结核病再教育，强调与患者沟通的重要性。 对于乍得国家结核病防治计划：发起关于结核病的公共信息、教育和宣传运动。在全国范围内实施直接督导下的短程化疗。 对于医生：加强与患者的沟通。
