Zerbini E, Chirico M C, Salvadores B, Amigot B, Estrada S, Algorry G
National Institute of Respiratory Diseases Dr. Emilio Coni (ANLIS), Santa Fe, Argentina.
Int J Tuberc Lung Dis. 2008 Jan;12(1):63-8.
Public health care services in the provinces of Buenos Aires, Santa Fe, Jujuy and Santa Cruz, Argentina.
To evaluate delays in tuberculosis (TB) diagnosis and treatment and associated risk factors in departments and administrative areas of four Argentine provinces.
Cross-sectional survey including retrospective medical record review and patient interviews.
A total of 243 patients with smear-positive pulmonary TB and a mean age of 40 years were included in the study. The mean diagnostic delays were as follows: total delay 92.1 days (median 62.0); patient delay 58.8 days (median 31); health service delay 32.6 days (median 12.5). The mean treatment delay was 0.9 days (median 0). Associations were observed between patient delays of >30 days and residence in Jujuy, age >50 years, dependence on transport to the nearest public health service due to distance and presence of cough. The >60-day total diagnosis delay was associated with age >50 years and need for transport to the nearest public health service.
Diagnostic delay is an important problem in the areas studied, with patient delay being of most concern. Patient delay was associated with age >50 years, dependence on transport to the nearest public health service due to distance and presence of cough.
阿根廷布宜诺斯艾利斯省、圣菲省、胡胡伊省和圣克鲁斯省的公共卫生保健服务。
评估阿根廷四个省份各部门及行政区结核病（TB）诊断和治疗的延迟情况及相关危险因素。
横断面调查，包括回顾性病历审查和患者访谈。
共有243例痰涂片阳性肺结核患者纳入研究，平均年龄40岁。平均诊断延迟情况如下：总延迟92.1天（中位数62.0天）；患者延迟58.8天（中位数31天）；卫生服务延迟32.6天（中位数12.5天）。平均治疗延迟为0.9天（中位数0天）。观察到患者延迟超过30天与居住在胡胡伊省、年龄超过50岁、因距离需依赖交通工具前往最近的公共卫生服务机构以及咳嗽症状有关。总诊断延迟超过60天与年龄超过50岁以及需前往最近的公共卫生服务机构有关。
在所研究地区，诊断延迟是一个重要问题，其中患者延迟最为令人担忧。患者延迟与年龄超过50岁、因距离需依赖交通工具前往最近的公共卫生服务机构以及咳嗽症状有关。
