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北阿坎德邦瑞诗凯诗市公立医院肺结核患者的诊断、治疗延迟程度及其相关因素:一项横断面研究

The Extent of Delay in Diagnosis, Treatment and their Associated Factors among Tuberculosis Patients Attending Government Hospitals of Rishikesh, Uttarakhand: A Cross-Sectional Study.

作者信息

Supehia Sakshi, Singh Mahendra, Bahurupi Yogesh, Aggarwal Pradeep, Chandra Rishita, Sharma Nandita

机构信息

Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.

Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India.

出版信息

Recent Adv Antiinfect Drug Discov. 2024;19(2):137-147. doi: 10.2174/2772434418666230517151828.

Abstract

BACKGROUND

"Tuberculosis (TB) remains a major public health problem" worldwide, affecting almost all age groups. "Early diagnosis and prompt treatment are essential to significantly reducing the TB burden." However, a significant proportion of cases remain undiagnosed and untreated, which plays a vital role in the transmission of the disease and severity of the illness in the community in most developing countries.

AIMS & OBJECTIVES: This study aimed to assess "the extent of delay in diagnosis and treatment of TB patients" and to identify the major factors associated with such delays (whether patient or health system-related) among TB patients in Rishikesh.

METHODS

This descriptive cross-sectional study was conducted in Rishikesh Town, Dehradun District, Uttara khand, India. Total of 130 newly diagnosed TB patients were recruited as study participants who attended the government hospitals of Rishikesh, All India Institute of Medical Sciences, Rishikesh and S P S Government Hospital, Rishikesh. A universal sampling technique was used in this study.

RESULTS

The mean age of the study participant was 36.75 (Standard Deviation (SD), 17.6), and the median age was 34 years. Of the patients, 64.6% were men, and 35.4% were women. The extent of various delays, such as patient delay (median 16 days), diagnostic delay (median 78.5 days), treatment delay (median 4 days), health system delay (43 days), and total delay (median 81 days).

CONCLUSION

The misconception of any chronic disease may lead to a false diagnosis or long treatment for symptomatic relief; the absence of proper diagnostic tests and doctor shopping could be the reasons for the prolonged diagnostic delay. Therefore, by strengthening the collaboration between private and public practitioners in order to meet the expectations of the Government of India to achieve the goals of the "National Strategic Plan for ending TB" in India by providing good quality care for all patients.

摘要

背景

“结核病仍然是一个重大的全球公共卫生问题”,几乎影响所有年龄组。“早期诊断和及时治疗对于显著减轻结核病负担至关重要。”然而,相当一部分病例仍未得到诊断和治疗,这在大多数发展中国家疾病在社区中的传播和病情严重程度方面起着至关重要的作用。

目的

本研究旨在评估“结核病患者诊断和治疗的延迟程度”,并确定瑞诗凯诗结核病患者中与此类延迟相关的主要因素(无论是患者相关还是卫生系统相关)。

方法

本描述性横断面研究在印度北阿坎德邦德拉敦区瑞诗凯诗镇进行。总共招募了130名新诊断的结核病患者作为研究参与者,他们前往瑞诗凯诗的政府医院、全印度医学科学研究所瑞诗凯诗分院和瑞诗凯诗SPS政府医院就诊。本研究采用了普查抽样技术。

结果

研究参与者的平均年龄为36.75岁(标准差[SD],17.6),中位年龄为34岁。患者中,64.6%为男性,35.4%为女性。各种延迟的程度,如患者延迟(中位16天)、诊断延迟(中位78.5天)、治疗延迟(中位4天)、卫生系统延迟(43天)和总延迟(中位81天)。

结论

对任何慢性病的误解可能导致错误诊断或为缓解症状而进行长期治疗;缺乏适当的诊断测试和辗转就医可能是诊断延迟延长的原因。因此,通过加强私人和公共从业者之间的合作,以便通过为所有患者提供优质护理来满足印度政府的期望,从而实现印度“终结结核病国家战略计划”的目标。

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