延误钩端螺旋体病治疗的相关因素:斯里兰卡莫纳拉加拉地区的前瞻性研究

Prabha Kumari, J. Vidanapathirana, J. Amarasekara, Lilani Karunanayaka
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摘要

导言:钩端螺旋体病是一种威胁生命的人畜共患传染病,延迟就医与并发症和预后不良有关。本研究旨在分析莫纳拉加拉区钩端螺旋体病患者延迟就医的相关社会人口因素:方法:以莫那拉加拉县基层及以上医院收治的 450 名临床诊断为钩端螺旋体病的患者为对象,采用预先测试的访谈者管理问卷,对实验室确诊的钩端螺旋体病患者进行了一项医院描述性横断面研究,以分析与钩端螺旋体病患者延误就诊相关的因素:结果:在本研究期间,莫纳拉加拉县的钩端螺旋体病发病率为每 10 万人 59.8 例。 在双变量分析中,婚姻状况(OR=1.85;CI=1.02-3.33)、月收入(OR=2.63;CI=1.02-7.14)、到达医疗机构所需的时间(OR=4.95;CI=1.48-16.62)和交通费用(OR=2.73;CI=1.10-1.62)是与实验室确诊患者延迟就医有关的重要社会人口因素。73;CI=1.10-6.75),而年龄(OR=1.25;CI=0.68-2.28)、性别(OR=1.44;CI=0.69-2.98)、教育(OR=1.5;CI=0.88-2.77)、国籍(OR=1.64;CI=0.39-6.66)、职业(OR=1.01;CI=0.56-1.81)、家庭到医疗机构的距离(OR=1.44;CI=0.79-2.59)和旅行方式(OR=1.78;CI=0.92-3.57)的影响不显著。在对混杂因素的影响进行调整后,只有钩端螺旋体病的感染源与就诊延迟有显著关联(AOR=3.65;95% CI=1.48-8.98)。结论与建议:应更加重视对钩端螺旋体病感染源的认识,并需要全年提高人们的认识,以防止医疗并发症和死亡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors associated with delays in seeking treatment for leptospirosis: a prospective study in Monaragala District, Sri Lanka
Introduction: Leptospirosis is a life-threatening zoonotic infection and delayed seeking treatment has been associated with complications and poor prognosis. The aim of this study was to analyze socio-demographic factors associated with delays in seeking treatment of patients with leptospirosis in Monaragala District.Methods: A hospital-based descriptive cross-sectional study was conducted to analyze the factors associated with delays in seeking treatment of patients with leptospirosis using 450 clinically diagnosed leptospirosis patients admitted to base and above hospitals in Monaragala district, using a pretested interviewer administered questionnaire among laboratory confirmed leptospirosis.Results: The incidence of leptospirosis in Monaragala district during the study period from the present study was 59.8 per 100,000 population.  Significant socio-demographic factors associate with delays in seeking treatment by laboratory confirmed patients in bi variable analysis was marital status (OR=1.85; CI=1.02-3.33), monthly income (OR=2.63; CI=1.02-7.14), time taken to reach a health care facility (OR=4.95; CI=1.48-16.62) and cost of travel (OR=2.73; CI=1.10-6.75), while age (OR=1.25; CI=0.68-2.28), sex (OR=1.44; CI=0.69-2.98), education (OR=1.5; CI=0.88-2.77), nationality (OR=1.64; CI=0.39-6.66), occupation (OR=1.01; CI=0.56-1.81), distance from home to a health care facility (OR=1.44; CI=0.79-2.59) and mode of travel  (OR=1.78; CI=0.92-3.57) was not significant. After adjusting for the effect of confounders, only the source of infection of leptospirosis showed a significant association (AOR=3.65; 95% CI=1.48-8.98) with delay in seeking treatment. Conclusions and Recommendations: Awareness of the source of the leptospirosis infection should be more emphasized and raising awareness is needed all year to prevent medical complications and deaths.
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