蒙古结核病患者就医、诊断和治疗的延误:2018-2021 年监测数据分析。

IF 1 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Western Pacific Surveillance and Response Pub Date : 2024-02-21 eCollection Date: 2024-01-01 DOI:10.5365/wpsar.2024.15.1.1074
Larissa Otero, Tsolmon Boldoo, Anuzaya Purevdagva, Uranchimeg Borgil, Temuulen Enebish, Oyunchimeg Erdenee, Tauhid Islam, Fukushi Morishita
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引用次数: 0

摘要

传染性结核病(TB)的早期诊断和治疗对于实现《终结结核病战略》中规定的全球目标至关重要。利用基于病例的结核病监测数据,我们分析了 2018 年至 2021 年蒙古结核病患者在就医、诊断和治疗方面的延误情况。我们计算了 "诊断延误 "和 "治疗延误 "的中位数和四分位数间距(IQR)。"诊断延误 "是指从症状出现到确诊的时间,细分为 "就医延误"(从症状出现到首次到医疗机构就诊的时间)和 "医疗机构诊断延误"(从首次到医疗机构就诊到确诊的时间);"治疗延误 "是指从确诊到开始治疗的时间。我们还计算了 "总延迟",即从症状出现到开始治疗的时间。根据 13 968 名登记肺结核患者的数据,总延误时间的中位数估计为 37 天(IQR,19-76)。这主要是由于求医延迟造成的(中位数,23 天;IQR,8-53);相比之下,医疗机构的诊断延迟和治疗延迟相对较短(分别为中位数,1 天;IQR,0-7;中位数,1 天;IQR,0-7)。2021 年,男性和女性的就医延迟时间没有显著差异,但儿童的就医延迟时间短于成人,临床诊断的结核病例的就医延迟时间短于细菌学确诊的结核病例。东部地区的就医延迟时间最长(中位数为 44.5 天;IQR 为 20-87),乌兰巴托的就医延迟时间最短(中位数为 9 天;IQR 为 14-64)。不同性别、年龄组和结核病诊断类型的结核病治疗延迟时间相似,但复治病例和乌兰巴托居民的治疗延迟时间略长。在蒙古,减少结核病传播的工作应优先考虑减少就医延迟。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Delays in health seeking, diagnosis and treatment for tuberculosis patients in Mongolia: an analysis of surveillance data, 2018-2021.

Early diagnosis and treatment of infectious tuberculosis (TB) is essential to the attainment of global targets specified in the End TB Strategy. Using case-based TB surveillance data, we analysed delays in health seeking, diagnosis and treatment among TB patients in Mongolia from 2018 to 2021. We calculated the median and interquartile range (IQR) for "diagnostic delay," defined as the time from symptom onset to diagnosis, subdivided into "health-seeking delay" (time from symptom onset to first visit to a health facility) and "health facility diagnostic delay" (time from first health facility visit to diagnosis), and for "treatment delay," defined as the time from diagnosis to start of treatment. We also calculated "total delay," defined as the time from symptom onset to treatment start. Based on data for 13 968 registered TB patients, the median total delay was estimated to be 37 days (IQR, 19-76). This was mostly due to health-seeking delay (median, 23 days; IQR, 8-53); in contrast, health facility diagnostic delay and treatment delay were relatively short (median, 1 day; IQR, 0-7; median, 1 day; IQR, 0-7, respectively). In 2021, health-seeking delay did not differ significantly between men and women but was shorter in children than in adults and shorter in clinically diagnosed than in bacteriologically confirmed TB cases. Health-seeking delay was longest in the East region (median, 44.5 days; IQR, 20-87) and shortest in Ulaanbaatar (median, 9; IQR, 14-64). TB treatment delay was similar across sexes, age groups and types of TB diagnosis but slightly longer among retreated cases and people living in Ulaanbaatar. Efforts to reduce TB transmission in Mongolia should prioritize decreasing delays in health seeking.

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来源期刊
Western Pacific Surveillance and Response
Western Pacific Surveillance and Response PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
1.70
自引率
0.00%
发文量
23
审稿时长
15 weeks
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