在乌干达的可能结核病患者中,地理分布和诊断延迟的预测因素
E Ochom1, K O Robsky1,2, A J Gupta1,3,4
1Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda.
Public health action
|September 22, 2023
概括
没有发现结核病 (TB) 诊断延迟的地理热点. 相反,患者的年龄,婚姻状况和结核病知识是影响诊断延迟的关键因素.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 空间分析 空间分析
背景情况:
- 了解延迟结核病 (TB) 诊断的地理模式对于有针对性的公共卫生干预至关重要.
- 识别导致诊断延迟的因素可以改善患者的治疗结果,并减少结核病的传播.
研究的目的:
- 调查结核病的地理分布,并确定结核病诊断中的患者相关和卫生系统相关延迟的潜在热点.
- 在乌干达人口中确定与这些延迟相关的个别因素.
主要方法:
- 在乌干达公共卫生项目中对接受结核病评估的成年人进行二次分析.
- 利用全球莫兰的I和Getis-OrdGI*统计数据来评估空间聚类和诊断延迟的热点.
- 采用多变量逻辑回归来确定患者和卫生系统延迟的预测因素.
主要成果:
- 在子县级观察到参与者的显著聚类,但没有确定结核病诊断延迟的统计学上显著的地理热点.
- 33%的参与者经历了与患者有关的延迟,57%的参与者经历了与卫生系统有关的延迟.
- 结婚与患者延迟减少有关,而年龄较大的年龄组 (38-57岁) 患者延迟增加. 对结核病的了解有助于防止卫生系统的延迟.
结论:
- 在本研究中没有确定结核病诊断延迟的地理热点.
- 个人因素,包括年龄,婚姻状况和对结核病的了解,与诊断延迟有显著联系.
- 干预措施应侧重于解决这些个人层面的决定因素,而不是仅仅针对地理目标.
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