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埃塞俄比亚南部锡达莫地区戴尔区和耶尔加莱姆镇行政公共卫生机构的肺结核患者的结核病治疗延迟及相关因素。

Tuberculosis treatment delay and associated factors among pulmonary tuberculosis patients at public health facilities in Dale District and Yirgalem Town administration, Sidama Region, South Ethiopia.

机构信息

Sidama Region Health Department, Sidama Region, Hawassa, Ethiopia.

School of Public Health, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia.

出版信息

BMC Infect Dis. 2024 May 23;24(1):517. doi: 10.1186/s12879-024-09397-8.

Abstract

BACKGROUND

Tuberculosis (TB) treatment delay is one of the major challenges of TB care in many low-income countries. Such cases may contribute to an increased TB transmission and severity of illness. The aim of this study was to determine the magnitude of patient delay in TB treatment, and associated factors in Dale District and Yirgalem Town administration of Sidama Region, Southern Ethiopia.

METHODS

Between January 1-Augst 30/ 2022, we studied randomly selected 393 pulmonary TB cases on Directly Observed Treatment Short course (DOTS) in Dale District and Yirgalem Town Administration. After conducting a pretest, we interviewed participants on sociodemographic, health seeking behavior and clinical factors and reviewed the TB registry. Trained enumerators interviewed to collect data. We entered data in to EPI-info 7 version 3.5.4 and then exported to the Statistical Package for Social Science (SPSS) version 23 for analysis. Multivariable logistic regression was used to identify associated factors of TB and statistical significance was defined using the 95% confidence interval.

RESULT

A total of 393 (98%) participants involved in the study. The magnitude of delay in TB treatment among the study participants was 223 (56.7%) (95% CI (51.8 - 61.6%)). Distance of the health facility from home, (adjusted odds ratio (AOR) = 2.04, 95% CI (1.3, 3.2)), seeking antibiotic treatment before being diagnosed for TB (AOR = 2.1, 95% CI (1.3, 3.5)) and the knowledge of TB prevention and treatments (AOR = 5.9, 95% CI (3.6, 9.8)), were factors associated with delay in TB treatment.

CONCLUSION

The prevalence of TB treatment delay among pulmonary TB patients in the study setting was high. Delay in TB treatment was associated with knowledge, behavioral and accessibility related factors. Providing health education and active case finding of TB would help in minimizing the delay.

摘要

背景

在许多低收入国家,结核病(TB)治疗延迟是结核病护理面临的主要挑战之一。这种情况可能导致结核病传播增加和病情加重。本研究旨在确定戴尔区和锡达马地区耶尔加莱姆镇行政当局的结核病患者治疗延迟的程度及其相关因素。

方法

2022 年 1 月 1 日至 8 月 30 日,我们对戴尔区和耶尔加莱姆镇行政当局的 393 例肺结核病例进行了随机选择。在进行预测试后,我们对参与者进行了社会人口统计学、求医行为和临床因素的访谈,并查阅了结核病登记册。经过培训的普查员进行访谈以收集数据。我们将数据输入 EPI-info 7 版本 3.5.4,然后导出到统计软件包社会科学(SPSS)版本 23 进行分析。多变量逻辑回归用于确定结核病的相关因素,定义统计学意义使用 95%置信区间。

结果

共有 393 名(98%)参与者参与了研究。研究参与者中结核病治疗延迟的程度为 223 名(56.7%)(95%CI(51.8-61.6%))。医疗机构与家庭的距离(调整后的优势比(AOR)=2.04,95%CI(1.3,3.2)),在被诊断为结核病之前寻求抗生素治疗(AOR=2.1,95%CI(1.3,3.5))和结核病预防和治疗知识(AOR=5.9,95%CI(3.6,9.8))是与结核病治疗延迟相关的因素。

结论

在研究环境中,肺结核患者的结核病治疗延迟率很高。结核病治疗延迟与知识、行为和可及性相关因素有关。提供健康教育和积极的结核病发现将有助于最大限度地减少延迟。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/783c/11112870/3f240f507fbc/12879_2024_9397_Fig1_HTML.jpg

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