Basnet Rajendra, Hinderaker Sven Gudmund, Enarson Don, Malla Pushpa, Mørkve Odd
Centre for International Health, University of Bergen, Bergen, Norway.
BMC Public Health. 2009 Jul 14;9:236. doi: 10.1186/1471-2458-9-236.
Identifying reasons for delay in diagnosis and treatment of tuberculosis is important for the health system to find ways to treat patients as early as possible, and hence reduce the suffering of patients and transmission of the disease. The objectives of this study was to assess the duration of delay in the diagnosis of tuberculosis and to investigate its determinants.
A cross-sectional survey was conducted using a structured questionnaire in 307 new tuberculosis patients registered by the National Tuberculosis Programme (NTP) in all DOTS centres in Banke district of Nepal.
The median patient delay was 50 days, the median health system delay was 18 days, and the median total delay was 60 days. Sputum smear negative participants had significantly lower risk of patient delay. Smokers using >5 cigarettes per day had higher risk of patient delay and health system delay.
Total delay in the diagnosis of tuberculosis in Banke district is shorter compared to other places in Nepal and neighbouring countries. The shorter delay for smear negative pulmonary tuberculosis raises suspicion that many of these patients are not examined according to the NTP manual before being diagnosed. Increasing public awareness of the disease and expansion of the facilities with assured quality could be helpful to reduce the delay in the diagnosis of tuberculosis.
确定结核病诊断和治疗延迟的原因对于卫生系统找到尽早治疗患者的方法非常重要，从而减轻患者痛苦并减少疾病传播。本研究的目的是评估结核病诊断的延迟时间并调查其决定因素。
在尼泊尔班凯区所有直接观察短程治疗（DOTS）中心，对国家结核病规划（NTP）登记的307名新结核病患者使用结构化问卷进行了横断面调查。
患者中位延迟时间为50天，卫生系统中位延迟时间为18天，总中位延迟时间为60天。痰涂片阴性参与者的患者延迟风险显著较低。每天吸烟超过5支的吸烟者患者延迟和卫生系统延迟风险较高。
与尼泊尔其他地区和邻国相比，班凯区结核病诊断的总延迟时间较短。涂片阴性肺结核的延迟时间较短令人怀疑，许多此类患者在诊断前未按照NTP手册进行检查。提高公众对该疾病的认识并扩大有质量保证的设施可能有助于减少结核病诊断的延迟。
