关键词:

肺结核, 就诊延误, 诊断延误, 广州

Abstract:

Objective　To analyze the characteristics of diagnosis and treatment delay of patients with tuberculosis in recent years at Yuexiu, and to provide the basic basis for the formulation of control strategies for the early detection of tuberculosis cases and the optimization and improvement of the implementation measures. Methods　The online reporting data of tuberculosis patients at Yuexiu District, Guangzhou from 2018 to 2022 were derived from the Tuberculosis Management Information System of China Information System for Disease Control and Prevention. Whether the intervals between the first diagnosis date and present symptom date and between the present diagnosis date and the present first diagnosis date were over 14 days were referred to as delay in seeing a doctor and diagnosis delay, respectively. The data of these two kinds of delay were statistically analyzed by day, week, month, and year. And the delays between male and female, between the juvenile group (< 18), the youth group (18-45), the middle-aged group (45-60), and the elderly group (≥60), and between the delay of each street were compared. χ² test and rank sum test were applied. Results　In the 2 504 cases of pulmonary tuberculosis, the rates of delay in seeing a doctor and diagnosis delay were 41.5% (1 028/2 504) and 30.71% (769/2 504), respectively. The ranges and medians of the two kinds of delays were 1-7 664 days and 27 days and 1-1 100 days and 14 days, respectively; the percentages of delay for one month, one year, and over one year were 52.72% (542/1 028), 43.29% (445/1 028), and 3.99% (41/1 028) and 77.76% (598/769), 21.59% (166/769), and 0.65% (5/769), respectively. The delay in seeing a doctor and diagnosis delay occurred in 662 cases (40.89%) and 482 cases (29.96%) among the 1 619 male patients, respectively, while 366 cases (41.36%) and 287 cases (32.43%) experienced the delays among the 885 female patients, respectively, with no statistical differences between the males and the females (all P˃0.05). The rates of delay in seeing a doctor and diagnosis delay in the juvenile group, the youth group, the middle-aged group, and the elderly group were 36.36% (16/44), 38.31% (321/838), 41.81% (268/641), and 43.12% (423/981) and 31.82% (14/44), 33.77% (283/838), 28.55% (183/641), and 29.46% (289/981), respectively, with no statistical differences (all P˃0.05). In the 18 sub-districts of Yuexiu District, the ranges of the rates of delay in seeing a doctor and diagnosis delay were 32.91%-50.79% and 21.52%-34.73%, respectively, with statistical differences (U=96.0 and 41.5; both P<0.05). Conclusions　There are high proportions of delay in seeing a doctor and diagnosis delay among patients with pulmonary tuberculosis at Yuexiu District. How to shorten delay in seeing a doctor by strengthening the active case finding and to reduce diagnosis delay by improving clinical diagnosis and treatment is an urgent problem to be solved.

Key words:

Pulmonary tuberculosis, Delay in seeing a doctor, Diagnosis delay, Guangzhou