Ayalew Yibeltal Estemech, Yehualashet Fikadu Ambaw, Bogale Worknesh Akanaw, Gobeza Mengistu Berhanu
Department of Medical Nursing, University of Gondar, Gondar, Ethiopia.
Department of Community Health Nursing, University of Gondar, Gondar, Ethiopia.
Tuberc Res Treat. 2020 Sep 19;2020:1901890. doi: 10.1155/2020/1901890. eCollection 2020.
Delay in the diagnosis and treatment of tuberculosis exacerbates the disease and clinical outcomes. It further enhances transmission of the infection in the society as well as increased the severity of the illness and raised rate of mortality.
The major goal of this study is to determine the magnitude of delays in tuberculosis treatment and factors affecting tuberculosis treatment among adult tuberculosis patients at Debremarkos town, North West Ethiopia, 2018.
Institution-based cross-sectional study design was employed. Systematically selected 300 adult TB patients were recruited to the study. The study was conducted at Debremarkos town public health facilities from March 1 to April 30, 2018. Logistic regression models were fitted to identify the predicting variables and control confounder's of the outcome variables. value ≤ 0.05 with 95% CI was considered as an indicator for the presence of statistically significant association. The result revealed that the median total delay was 23 days (IQR: 19-28 days). The median patient and health system delays were 20 days (IQR: 15-20 days) and 4 days (IQR: 3-5 days), respectively. Tuberculosis patients living in a rural area were 1.14 times more likely to delay for the TB treatment (AOR: 1.141, 95% CI (1.106, 2.608)). Patients who were unable to read and write have almost two times a chance of being delayed (AOR: 2.350, 95% CI (1.630, 2.608)). Monthly income of patients has found another predictor for delay; patients with low monthly income were about six times more likely to delay for TB treatment (AOR: 6.375, 95% CI: (1.733, 23.440)). Those TB patients who had visiting traditional healers before arrival to health facilities were about 2.7 times more likely to delay for TB treatment(AOR: 2.795, 95% CI (1.898, 8.693)). . The significant proportion of delays in tuberculosis treatment was found in this study. Living in the rural area, unable to read and write, lower monthly income, and visiting traditional healers were found independent predictors of TB treatment delay. The regional and zonal health administrator shall design various awareness creation mechanisms to educate the public about timely initiation of tuberculosis treatment.
结核病诊断和治疗的延迟会加剧病情和影响临床结局。这进一步增加了社会中感染的传播，同时也加重了疾病的严重程度并提高了死亡率。
本研究的主要目标是确定2018年埃塞俄比亚西北部德布雷马科斯镇成年结核病患者的结核病治疗延迟程度以及影响结核病治疗的因素。
采用基于机构的横断面研究设计。系统选取300名成年结核病患者纳入研究。研究于2018年3月1日至4月30日在德布雷马科斯镇的公共卫生设施中进行。采用逻辑回归模型来识别预测变量并控制结果变量的混杂因素。P值≤0.05且95%置信区间被视为存在统计学显著关联的指标。结果显示，总延迟中位数为23天（四分位间距：19 - 28天）。患者和卫生系统延迟的中位数分别为20天（四分位间距：15 - 20天）和4天（四分位间距：3 - 5天）。居住在农村地区的结核病患者延迟结核病治疗的可能性高1.14倍（调整后比值比：1.141，95%置信区间(1.106, 2.608)）。无法读写的患者延迟的可能性几乎高出两倍（调整后比值比：2.350，95%置信区间(1.630, 2.608)）。患者的月收入是延迟的另一个预测因素；月收入低的患者延迟结核病治疗的可能性高出约六倍（调整后比值比：6.375，95%置信区间：(1.733, 23.440)）。那些在前往卫生设施之前看过传统治疗师的结核病患者延迟结核病治疗的可能性高出约2.7倍（调整后比值比：2.795，95%置信区间(1.898, 8.693)）。本研究发现结核病治疗存在显著比例的延迟。居住在农村地区、无法读写、月收入较低以及看过传统治疗师是结核病治疗延迟的独立预测因素。地区和分区卫生管理人员应设计各种提高认识的机制，以教育公众及时开始结核病治疗。
