Chaychoowong Kampanart, Watson Roger, Barrett David I
Sirindhorn College of Public Health Chonburi, Mueang, Chonburi, Thailand.
University of Hull, England, UK.
J Infect Prev. 2022 Sep;23(5):222-227. doi: 10.1177/17571774221094164. Epub 2022 May 6.
Pulmonary tuberculosis (PTB) is a major health problem in Thailand. Delay in getting treatment is an important factor which may worsen the disease and increase TB transmission.
This study aimed to investigate the duration and predictors of patient delay among PTB patients in Northeast Thailand.
A cross-sectional study was undertaken using a structured questionnaire in nine districts in Nakhon Ratchasima Province from July to September 2018. The duration between the first symptom onset and the first visit to a health facility was determined, with a period of greater than 30 days defined as patient delay. Multiple logistic regression was used to identify predictors of the delay.
300 PTB patients participated in the survey, with patient delay identified in 39% of respondents. The median duration of the delay was 35 days among participants overall. Through multivariate analysis, primary education, upper secondary education, previous TB knowledge, TB recognition, TB stigmatisation, weight loss, self-treatment, the number of visits with health providers and using a motorcycle to travel to the hospital were significant predictors of patient delay.
Knowledge needs to be provided to people to increase their recognition and minimise stigmatisation of TB. Education about TB screening needs to be revised and delivered to health providers to increase and improve TB detection processes.
肺结核（PTB）是泰国的一个主要健康问题。延迟治疗是一个重要因素，可能会使病情恶化并增加结核病传播。
本研究旨在调查泰国东北部肺结核患者的患者延迟时长及预测因素。
2018年7月至9月，在呵叻府的9个区使用结构化问卷进行了一项横断面研究。确定首次症状出现与首次前往医疗机构就诊之间的时长，将超过30天的时间段定义为患者延迟。采用多元逻辑回归来确定延迟的预测因素。
300名肺结核患者参与了调查，39%的受访者存在患者延迟。总体参与者中延迟的中位时长为35天。通过多变量分析，小学教育、高中教育、既往结核病知识、结核病认知、结核病污名化、体重减轻、自我治疗、与医疗服务提供者就诊的次数以及使用摩托车前往医院是患者延迟的显著预测因素。
需要向人们提供知识，以提高他们对结核病的认知并尽量减少对结核病的污名化。需要修订并向医疗服务提供者提供有关结核病筛查的教育，以增加和改善结核病检测流程。
