Delay in the diagnosis and management of tuberculosis among patients in the Suez Canal Area

IF 1 Q4 RESPIRATORY SYSTEM
N. M. A. Elsaid, A. Refaat, Lamiaa A. Fiala, Eman R. Hamed
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引用次数: 0

Abstract

Background Delayed diagnosis of tuberculosis (TB) can enhance the transmission of infection and worsen prognosis. Aim To identify the risk factors of delay in the management of TB cases for early management. Patients and methods A cross-sectional analytic study was performed to assess the proportion, duration of delay, and its determinants in the diagnosis and management of TB. To assess the risk factors of delay, the sample was dichotomized into ‘delay’ and ‘nondelay’ groups taking the median total delay in the diagnosis and management of TB as a cutoff point. The study included 183 TB patients, who were registered in TB records during the study period (first of January to end of June, 2017). Data were collected by an interview questionnaire. Results Nearly half of patients (49.20%) had unacceptable total delay in the diagnosis and management of TB. The median of total delay, patient delay, and health-care system delay were 65, 14, and 20 days, respectively. Significant risk factors of total delay in the diagnosis and management of TB were not consulting the health-care provider after onset of symptoms (P=0.002), visiting initially the health facility other than the chest hospital/TB clinics (P=0.019), not consulting a chest physician initially (P=0.043), negative sputum smear (P=0.001), more than two health visits before initial diagnosis (P<0.001), while low-degree TB stigma was protective (P=0.006). Conclusion Nearly half of patients had unacceptable total delay in the diagnosis and management of TB. The main determinants were seeking pharmacies instead of visiting health-care providers, not visiting initially chest hospital/TB clinics, not consulting a chest physician initially, negative sputum smear, and more than two health visits before initial diagnosis.
苏伊士运河地区结核病患者诊断和治疗的延误
背景结核(TB)的延迟诊断可增加感染的传播并恶化预后。目的探讨结核病患者延误治疗的危险因素,为早期治疗提供依据。患者和方法进行了一项横断面分析研究,以评估结核病诊断和管理中延迟的比例、持续时间及其决定因素。为了评估延迟的危险因素,将样本分为“延迟”组和“非延迟”组,以结核病诊断和管理的总延迟中位数作为截止点。该研究包括183名结核病患者,他们在研究期间(2017年1月1日至6月底)在结核病记录中登记。数据通过访谈问卷收集。结果近一半(49.20%)的患者在结核病的诊断和治疗中存在不可接受的总延误。总延迟、患者延迟和卫生保健系统延迟的中位数分别为65、14和20天。导致结核病诊断和管理全面延误的重要风险因素有:出现症状后未咨询卫生保健提供者(P=0.002)、最初访问胸科医院/结核病诊所以外的卫生机构(P=0.019)、最初未咨询胸科医生(P=0.043)、痰涂片阴性(P=0.001)、在最初诊断前进行两次以上的卫生检查(P<0.001),而结核病低程度的耻耻感具有保护作用(P=0.006)。结论近一半的患者在结核病的诊断和治疗上存在不可接受的总延误。主要决定因素是寻找药店而不是去卫生保健提供者,最初没有去胸科医院/结核病诊所,最初没有咨询胸科医生,痰涂片阴性,以及在初步诊断前进行两次以上的健康检查。
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来源期刊
Egyptian Journal of Bronchology
Egyptian Journal of Bronchology RESPIRATORY SYSTEM-
自引率
7.70%
发文量
56
审稿时长
9 weeks
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