Tuberculosis Centre 12, Yala, Thailand.
Int J Tuberc Lung Dis. 2010 Feb;14(2):181-7.
Delay in presentation to a health facility is an important concern for tuberculosis (TB) control. The effect of stigma on delay in seeking care for TB symptoms is not well studied, especially in the context of the human immunodeficiency virus (HIV) co-epidemic.
To estimate the association of TB and acquired immune-deficiency syndrome (AIDS) stigma on delay in seeking care for TB symptoms.
For 480 newly diagnosed patients with TB, time from first TB symptom to the first visit to a qualified provider was calculated. Stigma scales were administered to each patient to obtain a stigma score.
Among men, those with higher TB stigma had a small increase in delay times, while women had a small decrease in delay. Among patients presenting with hemoptysis, higher TB stigma was associated with a small increase in delay, while among patients presenting with fever or extra-pulmonary symptoms only, higher TB and AIDS stigma resulted in shorter delay times.
In a population with a relatively short median delay (26 days), the impact of TB and AIDS stigma translates into a minimal change in delay time. This suggests that stigma does not have a clinically relevant effect on TB patient delay in southern Thailand.
延迟到医疗机构就诊是结核病（TB）控制的一个重要关注点。耻辱感对寻求结核病症状治疗的延迟的影响尚未得到充分研究，特别是在人类免疫缺陷病毒（HIV）流行的背景下。
评估结核病和获得性免疫缺陷综合征（AIDS）耻辱感对结核病症状就诊延迟的影响。
对 480 名新诊断的结核病患者进行了研究，从首次出现结核病症状到首次就诊于合格提供者的时间被计算出来。对每位患者进行了耻辱感量表评估，以获得耻辱感评分。
在男性中，TB 耻辱感较高的患者延迟时间略有增加，而女性的延迟时间略有减少。在出现咯血的患者中，较高的 TB 耻辱感与延迟时间略有增加相关，而在仅出现发热或肺外症状的患者中，较高的 TB 和 AIDS 耻辱感导致延迟时间缩短。
在一个中位数延迟时间相对较短（26 天）的人群中，TB 和 AIDS 耻辱感的影响转化为对延迟时间的微小变化。这表明在泰国南部，耻辱感对结核病患者的延迟就诊没有临床相关影响。
