Soumare Dianguina, Baya Bocar, Ouattara Khadidia, Kanoute Tenin, Sy Cheick M, Karembé Seydou, Guindo Ibrahima, Coulibaly Lamine, Kamian Youssouf, Dakouo Aime P, Sidibe Fatoumata, Koné Salif, Kone Drissa, Yossi Oumar, Berthe Gaoussou, Toloba Yacouba
Service of Pneumology of the University Teaching Hospital of Point-G, Bamako, Mali.
University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali.
J Tuberc Res. 2022 Mar;10(1):45-59. doi: 10.4236/jtr.2022.101004. Epub 2022 Mar 25.
Tuberculosis was the deadliest infectious agent before covid-19; 1.5 million deaths in 2020. Despite, a variety, of easy and cheap diagnostic tools, detection rates still fall below 90%; diagnosis delays are long exceeding 30 days in many continents. This study aimed to determine risk factors for pulmonary TB diagnosis delays in Mali.
A cross-sectional study was conducted in Bamako to include pulmonary TB patients at treatment initiation centers. Verbal consent was obtained before the interview. Demographics, clinical, treatment cost, and patient, medical, and diagnostic delays were computed using SPSS 25.0 considering a significance level p < 0.05.
In total 266 patients were included, 80.8% were male, mean age was ± 12 years, primary education level was 50.4%, treatment cost before diagnosis was 100 - 200 thousand CFA in 65.4%, smokers were 42.1%, median patient, medical and total diagnostic delays were 58, 57 and 114 days respectively. Education level below university, social reasons, and non-request of health workers were identified as independent risk factors for diagnostic delay > 100 days in Mali.
Diagnostic delay is relatively very long in Mali, there is an urgent need for identification and action to shorten the delays to limit the transmission chain and avoid disabling pulmonary sequels.
在新冠疫情之前，结核病是最致命的传染病；2020年有150万人死亡。尽管有各种简单且廉价的诊断工具，但检测率仍低于90%；在许多大洲，诊断延误时间很长，超过30天。本研究旨在确定马里肺结核诊断延误的风险因素。
在巴马科进行了一项横断面研究，纳入治疗起始中心的肺结核患者。在访谈前获得口头同意。使用SPSS 25.0计算人口统计学、临床、治疗费用以及患者、医疗和诊断延误情况，显著性水平设定为p < 0.05。
共纳入266例患者，80.8%为男性，平均年龄为±12岁，小学教育水平占50.4%，65.4%的患者诊断前治疗费用为10万至20万非洲法郎，吸烟者占42.1%，患者、医疗和总诊断延误的中位数分别为58天、57天和114天。大学以下教育水平、社会原因以及卫生工作者未提出检查要求被确定为马里诊断延误>100天的独立风险因素。
在马里，诊断延误时间相对很长，迫切需要识别并采取行动缩短延误时间，以限制传播链并避免肺部后遗症导致残疾。
