School of Health and Population Sciences, University of Birmingham, Room 240, Edgbaston, Birmingham B15 2TT, UK.
J Public Health (Oxf). 2013 Mar;35(1):12-20. doi: 10.1093/pubmed/fds046. Epub 2012 Jun 21.
TB remains a significant problem in the UK with the West Midlands having the highest incidence after London. Treatment is usually for a minimum of 6 months and requires a high level of compliance. We investigated potential determinants of delays and completion of treatment for tuberculosis (TB) in the West Midlands, UK.
We used data on 4840 patients with TB in the West Midlands from the Enhanced Tuberculosis Surveillance database from 1 January 2005 to 1 October 2010. We used regression models to investigate the cross-sectional association between sociodemographic and clinical risk factors and the timeliness and completion of TB treatment.
Patients with TB waited 82 days on average from symptom onset to treatment initiation. Female patients spent 6% longer time than males before receiving treatment [95% confidence interval (CI): 1.2-11.6%, P = 0.015]. Asian/Asian British patients were 11 times more likely to complete treatment than White patients (adjusted odds ratio: 11.4, 95% CI: 1.31-100.3, P = 0.028).
Females in the West Midlands took longer time to receive TB treatment than males, representing a health inequality that could be addressed through gender-sensitive awareness raising programmes. White patients were less likely to complete treatment than Asian/Asian British patients; additional support is needed in this group.
结核病在英国仍是一个严重的问题，西米德兰兹地区的发病率仅次于伦敦。治疗通常需要至少 6 个月的时间，并且需要高度的依从性。我们调查了英国西米德兰兹地区结核病（TB）治疗延迟和完成的潜在决定因素。
我们使用了 2005 年 1 月 1 日至 2010 年 10 月 1 日期间来自增强型结核病监测数据库的 4840 例结核病患者的数据。我们使用回归模型调查了社会人口统计学和临床危险因素与结核病治疗及时性和完成之间的横断面关联。
结核病患者从出现症状到开始治疗平均等待 82 天。女性患者比男性患者在接受治疗前多花费 6%的时间[95%置信区间（CI）：1.2-11.6%，P=0.015]。与白人患者相比，亚洲/亚裔英国患者完成治疗的可能性高 11 倍（调整后的优势比：11.4，95%CI：1.31-100.3，P=0.028）。
西米德兰兹地区的女性比男性接受结核病治疗的时间更长，这代表了一种健康不平等，可以通过针对女性的提高认识方案来解决。与亚洲/亚裔英国患者相比，白人患者完成治疗的可能性较低；这个群体需要额外的支持。
