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Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test
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意大利本土和移民人口之间结核病诊断延迟的差异:一项多中心研究
Francesco Di Gennaro1, Sergio Cotugno1, Giacomo Guido1
1Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, BA, Italy.
概括
移民结核病 (TB) 患者在意大利面临更长的患者相关诊断延迟 (PDD) 由于医疗保健获取障碍,而本地患者经历更长的卫生系统相关诊断延迟 (HDD). 这导致移民的诊断延迟总体较长,影响了结核病控制工作.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 结核病 (TB) 是一个重要的全球卫生问题,因诊断延迟而加剧.
- 了解不同人群的诊断延迟对于有效控制结核病至关重要.
研究的目的:
- 调查和比较意大利本地和移民结核病患者之间的诊断延迟 (与患者相关,与卫生系统相关和总量).
- 确定导致这两种诊断延迟的因素.
主要方法:
- 一项回顾性,多中心,横截面研究,涉及来自意大利10家医院的669例结核病例 (2018-2023年).
- 与患者相关的诊断延迟 (PDD),与卫生系统相关的诊断延迟 (HDD) 和本地人和移民群体之间的总诊断延迟 (TDD) 的比较.
- 分析社会人口统计数据和临床病史,以确定影响延迟的因素.
主要成果:
- 与本地人相比,移民结核病患者的PDD显著更长 (90 vs 10天),但HDD较短 (5 vs 40天).
- 移民的总诊断延迟 (TDD) 是较长的 (96 vs 65天).
- 移民也显示出更高的蒂米卡分数,更长的唾液转换时间,以及对随访的损失增加.
结论:
- 移民面临着大量的医疗保健接入障碍,导致更长的PDD.
- 本地人经历了更长的HDD,这可能表明在低流行地区对结核病的认可不足.
- 未来的战略应解决社会决定因素和医疗保健提供者培训,以减少结核病诊断延迟.
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