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与巴西结核病例死后报告相关的因素,2014年
Ursila Manga Aridja1, Marli Souza Rocha2, Patrícia Bartholomay2
1Universidade de Brasília, Brasília, Brasil.
Cadernos de saude publica
|June 28, 2023
概括
巴西的结核病 (TB) 死亡更有可能在老年人,受教育程度低,营养不良和生活在弱势地区的人群中死后报告. 改善获得诊断和治疗的机会至关重要.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 传染性疾病 传染性疾病
背景情况:
- 结核病 (TB) 仍然是一个重大的全球卫生挑战,每年有数以百万计的病例和死亡报告.
- 及时诊断和治疗对于结核病的恢复至关重要,因为85%的患者通过适当的治疗得到治愈.
- 对结核病例的死后通知表明无法获得有效治疗,突显了医疗保健方面的差异.
研究的目的:
- 为了确定与巴西死后报告的结核病例相关的因素.
- 了解与延迟结核病诊断和治疗相关的个人和市政当局的特点.
- 为改善结核病例检测和管理的公共卫生战略提供信息.
主要方法:
- 一项嵌套病例控制研究使用来自巴西可报告疾病信息系统 (SINAN) 的新结核病例队列进行.
- 分析包括个人特征 (年龄,教育,营养状况),市政因素 (M-HDI,贫困,规模,地区) 和卫生服务指标.
- 使用逻辑回归与层次分析模型来确定相关因素.
主要成果:
- 高龄 (≥60岁),低教育水平和营养不良显著增加了死后结核病报告的几率.
- 居住在人力发展指数 (M-HDI) 低,人口规模中等的市镇,特别是北方地区,与较高的死后通知率有关.
- 保护因素包括艾滋病毒-结核病共感染,恶性瘤,以及居住在具有广泛初级保健覆盖范围的地区.
结论:
- 易受伤害的群体,包括老年人,受教育程度较低,营养不良和服务不足地区的人,面临着更大的障碍,在巴西及时诊断和治疗结核病.
- 优先考虑这些群体的有针对性的干预措施对于减少与结核病相关的死亡率和改善治疗机会至关重要.
- 加强初级医疗保健覆盖率是减轻死后结核病通知风险的关键策略.
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