埃塞俄比亚北部提格雷地区西北部的肺结核患者的医疗保健寻求延迟。
Health care seeking delay among pulmonary tuberculosis patients in North West zone of Tigrai region, North Ethiopia.
机构信息
Department of Public Health, College of Health Science, Aksum University, P.O.Box: 298, Axum, Ethiopia.
Asgede Tsimbla Woreda Health Office, Tigrai, Ethiopia.
出版信息
BMC Infect Dis. 2019 Apr 5;19(1):309. doi: 10.1186/s12879-019-3893-7.
BACKGROUND
Tuberculosis (TB) is a major public health problem and it is among the top 10 causes of death worldwide. One of the challenges against attaining an effective TB control program is delay in seeking health care to diagnosis and treatment of TB patients. The aim of this study was to assess health care-seeking delay among pulmonary TB patients.
METHODS
An institutional based cross-sectional study was conducted among new pulmonary tuberculosis (PTB) patients > 15 years of age who were enrolled in the intensive phase TB treatment from November 1, 2015 - January 30, 2016. Data were collected by an interviewer administered technique using a structured questionnaire. Health care seeking delay was categorized by using a median cutoff point of > 30 days as a prolonged health care seeking delay. Logistic regression analyses were employed to determine factors independently associated with the delays in health care seeking.
RESULTS
A total of 422 PTB patients were included in this study. The median age of respondents was 37 years (interquartile range (IQR) =35-44). The median time of health care seeking delay was 30 days (IQR) = 21-60). Respondents occupation, knowledge about pulmonary tuberculosis, health facility visited first, seeking treatment from traditional or religious healers before visiting health facilities, reason for not seeking treatment early from health facilities, and reason for first consultation were found to be significantly associated with health care seeking delay.
CONCLUSION
The study showed the magnitude of health care seeking delay among pulmonary tuberculosis patient was very long and the factors associated with health care seeking delay were: occupation, knowledge status, health facility visited first and seeking treatment from religious or traditional healer before health facilities. To overcome delay of health care seeking among tuberculosis patients, efforts should required availing tuberculosis diagnostic and treatment services at the primary health care level.
背景
结核病（TB）是一个主要的公共卫生问题，也是全球十大死因之一。在实现有效的结核病控制计划方面面临的挑战之一是结核病患者寻求医疗保健以进行诊断和治疗的延迟。本研究的目的是评估肺结核患者的医疗保健寻求延迟。
方法
这是一项在 2015 年 11 月 1 日至 2016 年 1 月 30 日期间参加强化期结核病治疗的 15 岁以上新肺结核（PTB）患者中进行的基于机构的横断面研究。数据通过访谈者使用结构化问卷进行收集。使用 >30 天的中位数截止值来对医疗保健寻求延迟进行分类，作为延长的医疗保健寻求延迟。采用逻辑回归分析来确定与医疗保健寻求延迟相关的独立因素。
结果
共有 422 名 PTB 患者纳入本研究。受访者的中位年龄为 37 岁（四分位间距（IQR）= 35-44）。医疗保健寻求延迟的中位数为 30 天（IQR = 21-60）。受访者的职业、对肺结核的认识、首次就诊的医疗机构、在前往医疗机构之前寻求传统或宗教治疗师的治疗、未及早从医疗机构寻求治疗的原因以及首次就诊的原因均与医疗保健寻求延迟显著相关。
结论
该研究表明，肺结核患者的医疗保健寻求延迟程度非常长，与医疗保健寻求延迟相关的因素包括：职业、知识状况、首次就诊的医疗机构以及在前往医疗机构之前寻求宗教或传统治疗师的治疗。为了克服结核病患者寻求医疗保健的延迟，应努力在初级卫生保健层面提供结核病诊断和治疗服务。
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