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乌干达一家地区转诊医院中寻求治疗的肺结核患者的诊断和治疗延误情况:一项横断面研究。

Delays in diagnosis and treatment of pulmonary tuberculosis in patients seeking care at a regional referral hospital, Uganda: a cross sectional study.

作者信息

Muttamba Winters, Kyobe Samuel, Komuhangi Alimah, Lakony James, Buregyeya Esther, Mabumba Eldad, Basaza Robert K

机构信息

Makerere University Lung Institute, Makerere University College of Health Sciences, Kampala, Uganda.

Institute of Public Health and Management, International Health Sciences University, Kampala, Uganda.

出版信息

BMC Res Notes. 2019 Sep 18;12(1):589. doi: 10.1186/s13104-019-4616-2.

Abstract

OBJECTIVE

A cross-sectional survey involving 134 pulmonary TB patients started on TB treatment at the TB Treatment Unit of the regional referral hospital was conducted to ascertain the prevalence of individual and health facility delays and associated factors. Prolonged health facility delay was taken as delay of more than 1 week and prolonged patient delay as delay of more than 3 weeks. A logistic regression model was done using STATA version 12 to determine the delays.

RESULTS

There was a median total delay of 13 weeks and 110 (82.1%) of the respondents had delay of more than 4 weeks. Patient delay was the most frequent and greatest contributor of total delay and exceeded 3 weeks in 95 (71.6%) respondents. At multivariate analysis, factors that influenced delay included poor patient knowledge on TB (adjOR 6.904, 95% CI 1.648-28.921; p = 0.04) and being unemployed (adjOR 3.947, 95% CI 1.382-11.274; p = 0.010) while being female was found protective of delay; adjOR 0.231, 95% CI 0.08-0.67; p = 0.007). Patient delay was the most significant, frequent and greatest contributor to total delay, and factors associated with delay included being unemployed, low knowledge on TB while being female was found protective of delay.

摘要

目的

在地区转诊医院的结核病治疗科对134例开始接受结核病治疗的肺结核患者进行了横断面调查,以确定个体延误和医疗机构延误的患病率及相关因素。将医疗机构长时间延误定义为超过1周的延误,患者长时间延误定义为超过3周的延误。使用STATA 12版进行逻辑回归模型分析以确定延误情况。

结果

总延误的中位数为13周,110名(82.1%)受访者的延误超过4周。患者延误是总延误中最常见且最大的因素,95名(71.6%)受访者的患者延误超过3周。在多变量分析中,影响延误的因素包括患者对结核病的认知较差(调整后比值比6.904,95%置信区间1.648 - 28.921;p = 0.04)和失业(调整后比值比3.947,95%置信区间1.382 - 11.274;p = 0.010),而女性被发现可减少延误;调整后比值比0.231,95%置信区间0.08 - 0.67;p = 0.007)。患者延误是总延误中最显著、最常见且最大的因素,与延误相关的因素包括失业、对结核病的认知较低,而女性被发现可减少延误。

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