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南非林波波省结核病患者的地域流动性与就医时间。

Geographic mobility and time to seeking care among people with TB in Limpopo, South Africa.

机构信息

Department ofEpidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

出版信息

Int J Tuberc Lung Dis. 2021 Sep 1;25(9):708-715. doi: 10.5588/ijtld.21.0038.

Abstract

Human mobility contributes to the spread of infectious diseases. South Africa has a long history of internal labor migration and a high burden of TB. People newly diagnosed with TB in the Vhembe and Waterberg Districts of Limpopo answered a questionnaire regarding geographic movement over the past year. Participants were classified as 'highly mobile' (spending more than 30 nights at a residence other than their primary residence in the past year, or being ≥250 km from their primary residence at the time of the interview) or 'less mobile'. We explored associations between sociodemographic characteristics and high mobility, and between mobility and time to presentation at a clinic. Of the 717 participants included, 185 (25.7%) were classified as 'highly mobile'. Factors associated with high mobility included living with someone outside of Limpopo Province, HIV-positive status (men only), and current smoking (men only). Highly mobile individuals had similar care-seeking behavior as less mobile individuals (adjusted time ratio 0.9, 95% CI 0.6-1.2, = 0.304) Highly mobile people with TB in Limpopo Province were more likely to live with people from outside the province, smoke, and have HIV. These patients had similar delays in seeking care as less mobile individuals.

摘要

人口流动促进了传染病的传播。南非国内存在长期的劳动力迁移现象,结核病负担沉重。林波波省 Vhembe 和 Waterberg 地区新诊断出结核病的患者回答了一份关于过去一年地理移动的问卷。参与者分为“高度流动”(过去一年在常住地以外的地方居住超过 30 晚,或在接受采访时距离常住地超过 250 公里)或“低度流动”。我们探讨了社会人口特征与高度流动之间的关联,以及流动与就诊时间之间的关联。在纳入的 717 名参与者中,有 185 名(25.7%)被归类为“高度流动”。与高度流动相关的因素包括与林波波省以外的人居住、HIV 阳性(仅男性)和当前吸烟(仅男性)。高度流动的个体与低度流动的个体具有相似的就医行为(调整后的时间比值为 0.9,95%CI 0.6-1.2,P=0.304)。林波波省高度流动的结核病患者更有可能与来自外省的人居住、吸烟和感染 HIV。这些患者的就医延迟与低度流动的个体相似。

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本文引用的文献

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Migration and Health in Southern Africa: 100 years and still circulating.南部非洲的移民与健康:百年依旧流传
Health Psychol Behav Med. 2014 Jan 1;2(1):34-40. doi: 10.1080/21642850.2013.866898.

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