School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
Sci Rep. 2024 Aug 27;14(1):19799. doi: 10.1038/s41598-024-70283-z.
The spatial delays of pulmonary tuberculosis (PTB) have been less explored. In this study, a total of 151,799 notified PTB cases were included, with median patient and diagnostic delays of 15 [interquartile range (IOR), 4-35] and 2 (IOR, 0-8) days, respectively. The spatial autocorrelation analysis and spatial-temporal scan statistics were used to determine the clusters, indicating that the regions in the southwestern and northeastern parts of Zhejiang Province exhibited high rates of long-term patient delay (LPD, delay ≥ 15 days) and long-term diagnostic delay (LDD, delay ≥ 2 days). Besides, the Mantel test indicated a moderately positive correlation between public awareness of suspicious symptoms and the LPD rate in 2018 (Mantel's r = 0.4, P < 0.05). These findings suggest that PTB delays can reveal deficiencies in public health education and the healthcare system. Also, it is essential to explore methods to shift PTB knowledge towards real changes in attitude and behavior to minimize patient delay. Addressing these issues will be crucial for improving public health outcomes related to PTB in Zhejiang Province.
肺结核（PTB）的空间延迟现象尚未得到充分研究。本研究共纳入了 151799 例确诊的肺结核病例，患者和诊断延迟的中位数分别为 15 天（四分位距，4-35）和 2 天（四分位距，0-8）。采用空间自相关分析和时空扫描统计来确定聚集区域，结果表明，浙江省西南部和东北部地区的患者长期延迟（LPD，延迟≥15 天）和长期诊断延迟（LDD，延迟≥2 天）的比例较高。此外，Mantel 检验表明，2018 年公众对可疑症状的认识与 LPD 率之间存在中度正相关（Mantel's r=0.4，P<0.05）。这些发现表明，肺结核延迟现象可以揭示公共卫生教育和医疗体系的不足之处。还需要探索方法，将肺结核知识转化为态度和行为的真正改变，以最大程度地减少患者延迟。解决这些问题对于改善浙江省与肺结核相关的公共卫生结果至关重要。
