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埃塞俄比亚亚的斯亚贝巴公立和私立医疗机构中肺结核患者治疗延迟的相关因素

Factors Associated with Treatment Delay among Pulmonary Tuberculosis Patients in Public and Private Health Facilities in Addis Ababa, Ethiopia.

作者信息

Adenager Getinet Shewaseged, Alemseged Fessahaye, Asefa Henok, Gebremedhin Amanuel Tesfay

机构信息

Department of Epidemiology and Biostatistics, Jimma University, Jimma, Ethiopia.

Department of Population and Family Health, Jimma University, Jimma, Ethiopia.

出版信息

Tuberc Res Treat. 2017;2017:5120841. doi: 10.1155/2017/5120841. Epub 2017 Feb 27.

Abstract

. Early detection and diagnosis of tuberculosis (TB) and the timely commencement of antituberculosis (anti-TB) treatment are the parts of efficient tuberculosis prevention and control program. Delay in the commencement of anti-TB treatment worsens the prognosis and increases the risk of death and the chance of transmission in the community and among health care workers. . To assess tuberculosis treatment delay and associated factors among pulmonary TB patients in Addis Ababa, Ethiopia. . A cross-sectional study was conducted in 10 public and 10 private health facilities that provide TB treatment. The data were collected from 425 newly registered pulmonary TB patients using pretested structured questionnaire from April to June 2012. Data were entered in EPI info version 3.5.1 and analyzed using SPSS version 16.0. . The median durations of a patient, health care system, and total treatment delays were 17, 9, and 35 days, respectively. Overall 179 (42.1%), 233 (54.8%), and 262 (61.6%) of patients experienced patient delay, health care system delay, and total treatment delay, respectively. Distance more than 2.5 km from TB treatment health facility [AOR = 1.6, 95% CI (1.1-2.5)] and the presence of TB-associated stigma [AOR = 2.1, 95% CI (1.3, 3.4)] indicate higher odds of patient delay, whereas, being unemployed, patients with the hemoptysis symptom complain indicated lower odds of health care system delay [AOR = 0.41, 95% CI (0.24, 0.70)] and [AOR = 0.61 (0.39, 0.94)], respectively. . A significant proportion of clients experienced patient and health care system delay. Thus, there is a need for designing and implementing appropriate strategies to decrease the delays. Efforts to reduce delays should give focus on integrating prevention programs such as active case detection and expanding access to TB care.

摘要

结核病(TB)的早期发现与诊断以及抗结核治疗的及时启动是有效结核病预防与控制项目的组成部分。抗结核治疗启动延迟会使预后恶化,增加死亡风险以及在社区和医护人员中传播的几率。

为评估埃塞俄比亚亚的斯亚贝巴肺结核患者的结核病治疗延迟情况及相关因素。

在10家提供结核病治疗的公立和10家私立医疗机构开展了一项横断面研究。2012年4月至6月期间,使用预先测试的结构化问卷从425名新登记的肺结核患者处收集数据。数据录入EPI info 3.5.1版本,并使用SPSS 16.0版本进行分析。

患者、医疗系统及总治疗延迟的中位时长分别为17天、9天和35天。总体而言,分别有179名(42.1%)、233名(54.8%)和262名(61.6%)患者经历了患者延迟、医疗系统延迟和总治疗延迟。距离结核病治疗医疗机构超过2.5公里[AOR = 1.6,95% CI(1.1 - 2.5)]以及存在结核病相关耻辱感[AOR = 2.1,95% CI(1.3,3.4)]表明患者延迟的几率更高,而失业、有咯血症状主诉的患者医疗系统延迟几率较低,分别为[AOR = 0.41,95% CI(0.24,0.70)]和[AOR = 0.61(0.39,0.94)]。

相当一部分患者经历了患者和医疗系统延迟。因此,需要设计并实施适当策略以减少延迟。减少延迟的努力应着重于整合主动病例发现等预防项目以及扩大结核病治疗的可及性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e3c/5350388/025a13fe624e/TRT2017-5120841.001.jpg

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