1Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Asia Pac J Public Health. 2014 Jan;26(1):33-41. doi: 10.1177/1010539513502523. Epub 2013 Oct 4.
Few studies have examined, in a prospective cohort study, factors causing delay of access to tuberculosis (TB) diagnosis among new, active TB patients. A prospective cohort study (2009-2011) was carried out among 408 889 Chinese. Data on known/potential influencing factors were obtained from baseline questionnaires. We used stepwise logistic regression models to analyze the association between several known/potential influencing factors and diagnosis delay, assessed the current situation, and explored determinants of diagnosis delay. During follow-up and final visits, 202 new, active TB patients were found. Median patient delay was 5.4 (quartile 2.7-26) weeks, health system delay was 0 (quartile 0-1.6) weeks, and diagnosis delay was 9.9 (quartile 3.1-28.1) weeks. The influencing factors on patient delay were age and duration of symptoms. Smoking and sputum smear status were influencing factors for health system delay, and duration of symptoms was one of the factors for diagnosis delay. These findings provide information on the current situation of diagnosis delay and evidence for specific strategy development for TB control in China.
鲜有研究采用前瞻性队列研究的方法，来探究新确诊活动性肺结核患者延迟获得诊断的原因。本前瞻性队列研究（2009-2011 年）纳入了 408889 名中国人。从基线调查问卷中获取了有关已知/潜在影响因素的数据。我们采用逐步逻辑回归模型来分析若干已知/潜在影响因素与诊断延迟之间的关联，评估了当前的情况，并探讨了诊断延迟的决定因素。在随访和最终访视期间，发现了 202 例新确诊的活动性肺结核患者。患者延迟的中位数为 5.4（四分位距 2.7-26）周，卫生系统延迟为 0（四分位距 0-1.6）周，诊断延迟为 9.9（四分位距 3.1-28.1）周。影响患者延迟的因素是年龄和症状持续时间。吸烟和痰涂片状况是影响卫生系统延迟的因素，而症状持续时间是导致诊断延迟的因素之一。这些发现提供了关于诊断延迟现状的信息，为中国结核病控制的具体策略制定提供了依据。
