阿富汗坎大哈肺结核患者的诊断延迟及其预测因素:一项横断面分析研究。

IF 1.5 Q4 INFECTIOUS DISEASES
International Journal of Mycobacteriology Pub Date : 2025-07-01 Epub Date: 2025-09-15 DOI:10.4103/ijmy.ijmy_91_25
Hazratullah Bariz, Muhammad Haroon Stanikzai, Ghulam Mohayuddin Mudaser, Khalid Ahmad Stanikzai, Omid Dadras
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引用次数: 0

摘要

背景:结核病(TB)患者的诊断延迟导致抗结核治疗开始较晚,这与预后不良和结核病传播增加有关。尽管结核病有公认的负面后果,但在发展中国家,包括阿富汗,结核病患者的诊断延误很常见,在这些国家,关于其预测因素的证据有限。我们的目的是评估在阿富汗坎大哈医疗机构就诊的新诊断结核病患者的诊断延迟及其预测因素。方法:2025年2月至5月在坎大哈进行了一项多中心横断面研究。从6个卫生保健机构的结核病护理中心随机招募18岁或以上的新诊断结核病患者。结核病诊断的延误包括患者和卫生保健系统的延误。使用多变量逻辑回归模型确定诊断延迟的预测因子。结果:患者和卫生系统延误分别占44%和59.4%的病例。患者受教育程度低、肺外结核、距离医疗机构较远、有积极的自我药疗史是诊断延迟的重要预测因素。结论:尽管早期结核病诊断的益处已得到公认,但本研究表明,结核病诊断延迟仍然是坎大哈省的一个公共卫生挑战。结核病治疗延迟是与患者的教育程度、结核病类型、与医疗机构的距离以及自我用药史有关的因素造成的。因此,对这些因素给予额外关注可能会减少阿富汗结核病患者的诊断延误。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic Delay and its Predictors among Tuberculosis Patients in Kandahar, Afghanistan: A Cross-sectional Analytical Study.

Background: Diagnostic delay among tuberculosis (TB) patients leads to late anti-TB treatment initiation, which is associated with poor prognosis and increased TB transmission. Despite its recognized negative consequences, diagnostic delay among TB patients is common in developing countries, including Afghanistan, where evidence on its predictors is limited. We aimed to evaluate diagnostic delay and its predictors among newly diagnosed TB patients attending healthcare facilities in Kandahar, Afghanistan.

Methods: A multicenter, cross-sectional study was conducted in Kandahar between February and May 2025. Newly diagnosed TB patients aged 18 years or older were randomly recruited from the TB care centers of six healthcare facilities. Delays in TB diagnosis encompassed both patient and healthcare system delays. The predictors of diagnostic delay were identified using a multivariable logistic regression model.

Results: Patient and health system delays were noted in 44% and 59.4% of cases, respectively. Patients' low education level, extrapulmonary TB, longer distance to healthcare facility, and positive history of self-medication were significant predictors of diagnostic delays.

Conclusion: Despite the well-established benefits of early TB diagnosis, this study revealed that delay in TB diagnosis is still a public health challenge in Kandahar province. Late presentation for TB care was a result of factors that relate to the patient's education, TB type, distance to healthcare facility, and history of self-medication. Therefore, focusing extra attention on these factors could potentially reduce diagnostic delays among TB patients in Afghanistan.

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来源期刊
CiteScore
2.20
自引率
25.00%
发文量
62
审稿时长
7 weeks
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