贵州省盘州市肺结核病患者就诊延迟影响因素

目的 分析贵州省盘州市肺结核病患者就诊延迟的影响因素,为该市肺结核病的有效防控提供参考依据。方法 从中国疾病预防控制信息系统的结核病管理信息系统中导出盘州市2014年1月1日—2018年12月31日肺结核病患者的病案信息,采用非条件多因素Logistic回归分析肺结核病患者就诊延迟的危险因素。结果 盘州市2014年1月1日—2018年12月31共报告活动性肺结核病患者5 342例,有2 776例患者就诊延迟,就诊延迟率为51.97%,就诊中位天数为13 d （2~42 d）。单因素分析结果显示,年龄、居住地、户籍、职业、文化程度、患者来源和病原学检查结果为盘州市肺结核病患者就诊延迟的影响因素。多因素分析结果显示,>60岁（OR=2.61,95%CI：1.30~7.01）、郊区或农村（OR=1.67,95%CI：1.10~6.27）、农业和运输业（OR=2.35,95%CI：1.86~4.19）、转诊（OR=1.71,95%CI：1.22~4.21）及因症推荐（OR=1.70,95%CI：1.15~4.61）的患者发生就诊延迟的比例更高。结论 居住在郊区或农村、农业和运输业是盘州市肺结核患者就诊延迟的危险因素。盘州市肺结核患者就诊延迟率较高,应根据就诊延迟患者的特征,制定有效的干预措施。

Risk factors of care-seeking delay of patients with pulmonary tuberculosis in Panzhou,Guizhou

Objective To analyze the related risk factors of care-seeking delay of patients with pulmonary tuberculosis in Panzhou City, and we provide reference for the effective prevention and control of pulmonary tuberculosis in the city. Methods Data regarding tuberculosis (TB) patients was collected from the tuberculosis management information system(TMIS), a part of China information system for disease control and prevention from January 1, 2014 to December 31, 2018. Unconditional Logistic regression method was used to estimate the risk factors that associated with the care-seeking delay of patients. Results From January 1, 2014 to December 31, 2018, a total of 5 342 cases of active pulmonary tuberculosis patients were reported in Panzhou city, and there were 2 776 patients with delayed treatment, with a delay rate of 51.97%, a median number of 13 (2-42) days, and a delay rate of 51.97% (2 776).The results of single factor analysis showed that age, residence place, household registration, occupation, education level, patient source and etiological examination results were the influencing factors of the delay rate of pulmonary tuberculosis patients in Panzhou city.The results from the multivariate Logistic regression analysis showed that the age >60 years group (OR=2.61, 95%CI: 1.30-7.01), suburban or rural area (OR=1.67, 95%CI: 1.10~6.27), agriculture and transportation (OR=2.35, 95%CI: 1.86-4.19), referral (OR=1.71, 95%CI: 1.22-4.21), and disease-related recommendation (OR=1.70, 95%CI: 1.15-4.61) had higher rates of delayed medical treatment. Conclusions Residence in the suburbs or rural areas, agriculture and transportation were the risk factors of care-seeking delay of patients with pulmonary tuberculosis in Panzhou City. The delay rate of pulmonary tuberculosis patients in Panzhou city is relatively high, so effective intervention measures should be formulated according to the characteristics of patients with delayed treatment.