Pirkis J E, Speed B R, Yung A P, Dunt D R, MacIntyre C R, Plant A J
National Centre for Epidemiology and Population Health, Australian National University, Victoria, Australia.
Tuber Lung Dis. 1996 Oct;77(5):401-6. doi: 10.1016/s0962-8479(96)90111-2.
Fairfield Hospital, Victoria, Australia.
To examine delay in initiation of treatment for tuberculosis (TB).
Delay in the initiation of treatment for 142 notified TB patients was examined by a retrospective record review. Particular attention was given to the periods between (1) onset of symptoms and initiation of treatment, and (2) determination of sputum positivity and initiation of treatment. An expert panel nominated 30 days and 3 days as 'acceptable' periods for (1) and (2), respectively.
Only 31% of patients commenced treatment within 30 days of onset of symptoms. This was so for both sputum smear-positive and negative cases, and was not significantly related to the site of infection, referral source, age, gender or ethnicity of the patient. Of patients with smear-positive pulmonary TB, 86% received treatment within 3 days of this result being demonstrated. Those with a delay of greater than 3 days were all investigated by private doctors through private laboratories.
There are appreciable delays in initiation of treatment for TB. Measures to combat these unacceptable delays are discussed.
澳大利亚维多利亚州费尔菲尔德医院。
研究结核病（TB）治疗开始的延迟情况。
通过回顾性病历审查，对142例已通报的结核病患者治疗开始的延迟情况进行研究。特别关注以下两个时间段：（1）症状出现至治疗开始之间的时间段，以及（2）痰菌阳性判定至治疗开始之间的时间段。一个专家小组分别将30天和3天指定为（1）和（2）的“可接受”时间段。
仅31%的患者在症状出现后30天内开始治疗。痰涂片阳性和阴性病例均如此，且与感染部位、转诊来源、患者年龄、性别或种族无显著关联。痰涂片阳性的肺结核患者中，86%在结果显示后3天内接受了治疗。延迟超过3天的患者均由私人医生通过私人实验室进行了检查。
结核病治疗开始存在明显延迟。讨论了应对这些不可接受延迟的措施。
