Bhardwaj Ashok Kumar, Kashyap Surender, Bansal Pradeep, Kumar Dinesh, Raina Sunil Kumar, Chander Vishav, Sharma Sushant
Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh 176001, India.
Kalpana Chawla Government Medical College, Karnal, Haryana, India.
Pulm Med. 2014;2014:132047. doi: 10.1155/2014/132047. Epub 2014 Mar 6.
Early case identification and prompt treatment of new sputum smear positive case are important to reduce the spread of tuberculosis (TB). Present study was planned to study the associated factors for duration to contact the health facility since appearance of symptoms and treatment default. Methodology. It was prospective cohort study of TB patients already registered for treatment in randomly selected TB units (TUs) in Himachal Pradesh, India. Relative risk (RR) was calculated as risk estimate to find out the explanatory variables for early contact and default. Results. Total 1607 patients were recruited and 25 (1.5%) defaulted treatment. Patients from nuclear family (aRR: 1.37; 1.09-1.73), ashamed of TB (aRR: 1.32; 1.03-1.70), wishing to disclose disease status (aRR: 1.79; 1.43-2.24), but aware of curable nature (aRR: 1.67; 1.17-2.39) and preventable (aRR: 1.35; 1.07-1.70) nature of disease, contacted health facility early since appearance of symptoms. Conclusion. Better awareness and less misconceptions about disease influences the early contact of health facility and low default rate in North India.
早期发现新的痰涂片阳性病例并及时治疗对于减少结核病传播至关重要。本研究旨在探讨自出现症状以来与前往医疗机构就诊时间及治疗中断相关的因素。方法：这是一项对印度喜马偕尔邦随机选取的结核病治疗单位中已登记接受治疗的结核病患者进行的前瞻性队列研究。计算相对风险（RR）作为风险估计值，以找出早期就诊和治疗中断的解释变量。结果：共招募了1607名患者，其中25名（1.5%）中断治疗。来自核心家庭的患者（调整后RR：1.37；1.09 - 1.73）、因结核病感到羞耻的患者（调整后RR：1.32；1.03 - 1.70）、希望披露疾病状况的患者（调整后RR：1.79；1.43 - 2.24），但知晓疾病可治愈（调整后RR：1.67；1.17 - 2.39）及可预防（调整后RR：1.35；1.07 - 1.70）性质的患者，自出现症状后较早前往医疗机构就诊。结论：对疾病有更好的认知且较少误解会影响在印度北部较早前往医疗机构就诊以及较低的治疗中断率。
