Factors affecting delays in tuberculosis diagnosis in rural China: a case study in four counties in Shandong Province

被引:50
作者
Cheng, G
Tolhurst, R
Li, RZ
Meng, QY
Tang, S
机构
[1] Univ Liverpool Liverpool Sch Trop Med, EQUI TB Knowledge Programme, Liverpool L3 5QA, Merseyside, England
[2] Shandong Univ, Ctr Hlth Management & Policy, Shandong 250012, Peoples R China
[3] Shandong Ctr TB Control, Shandong, Peoples R China
关键词
tuberculosis; heatth-seeking behaviour; poverty; gender; China;
D O I
10.1016/j.trstmh.2004.07.005
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Improving case detection is an urgent and serious challenge for tuberculosis (TB) control in China. We investigated the extent to which TB patients delayed seeking TB care and health services delayed reaching a diagnosis, and socioeconomic factors associated with the delays. Standard questionnaires were administered to 190 new smear-positive TB patients who had completed treatment at TB dispensaries in four counties of Shandong Province in 2001. Multivariate analysis using Cox Regression showed that old age, tack of education and distance from home to a township health centre were significantly associated with delay in seeking care from service providers. In examining the delay between first contact with a service provider and diagnosis, we found that women experienced Longer delays than men, and that the higher the Level. of facility patients first visited, the Less time was needed to achieve a diagnosis. These two factors were statistically significant in multivariate Cox Regression analysis. We concluded that the elderly, the less educated, women, and those living far from health facilities face the Longest delays in reaching TB services and achieving diagnosis. (c) 2004 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:355 / 362
页数:8
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