Delay on care-seeking and influencing factors among adolescent tuberculosis patients in Dongguan City from 2009 to 2018

Abstract

Objective To analyze the characteristics and influencing factors of care-seeking delay of adolescent tuberculosis patients in Dongguan City from 2009 to 2018, so as to provide theoretical basis for the tuberculosis control.

Methods The study participants were 8 899 adolescent tuberculosis patients in Dongguan from 2009 to 2018. The Rank-sum test and multiple linear regression were used to analyze the influencing factors of care-seeking days, and the χ ² test and Logistic regression were used to analyze the influencing factors of care-seeking delay.

Results The median care-seeking days among adolescent tuberculosis patients were 18(6–46) days in Dongguan City from 2009 to 2018, and the prevalence of the care-seeking delay was 56.6%. Multiple linear regression indicated that care-seeking delays were positively associated with being women ( B = 0.20), living in rural areas ( B = 10), pathogen-positive patients ( B = 0.69), patients from 2014 to 2018 ( B = 0.21), and junior school students ( B = 0.98). Multivariate Logistic regression indicated that care-seeking delay were positively associated with being women ( OR = 1.35, 95% CI = 1.23–1.47), living in rural areas ( OR = 1.21, 95% CI = 1.08–1.37), pathogen-positive patients ( OR = 2.51, 95% CI =2.26–2.79), patients from 2014 to 2018 ( OR = 1.24, 95% CI = 1.14–1.35), junior-school students ( OR = 7.58, 95% CI = 1.45–39.65), high-school students ( OR = 5.26, 95% CI = 1.04–26.52), university students ( OR = 7.06, 95% CI = 1.39–35.99), and non-students ( OR = 5.23, 95% CI = 1.05 – 26.08) ( P<0.05).

Conclusion The prevention and control of tuberculosis among adolescent patients in Dongguan urgently needs to be strengthened. In the future, attention should be paid to the prevalence of care-seeking delay among female, rural, and student tuberculosis patients, and a reasonable prevention and control policy for adolescent patients should be formulated.

Abstract

【摘要】 目的 分析 2009—2018 年东莞市青少年结核病患者就诊延迟特征及其影响因素, 为青少年结核病防控工作提供 理论依据。 方法 以 2009—2018 年东莞市 8 899 例 10~24 岁青少年结核病患者作为研究对象, 采用秩和检验和多重线性 回归分析就诊天数的影响因素, 采用妒检验和Logistic回归分析探究就诊延迟率的影响因素。 结果 2009—2018 年东莞 市青少年结核病患者就诊天数的中位数为 18 (6~46)d, 就诊延迟率为56.6%。多重线性回归提示, 女性 ( B = 0.20)、居住郊 区 ( B = 0.10)、病原学阳性 ( B = 0.69)、2014—2018 年 ( B = 0.21)、初中患者 ( B = 0.98) 与就诊天数增加呈正相关 ( P 值均< 05)。多因素 Logistic 回归分析提示, 女性 ( OR = 1.35,95% CI = 1.23~1.47)、居住郊区 ( OR = 1.21, 95% CI = 1.08~1.37)、病 原学阳性 ( OR = 2.51, 95% CI =2.26~2.79)、2014—2018 年 ( OR = 1.24,95% CI = 1.14~1.35)、初中 ( OR = 7.58,95% CI = 1.45~39.65)、髙中 ( OR = 5.26, 95% CI = 1.04~26.52)、大学 ( OR = 7.06, 95% CI = 1.39~ 35.99)、非学生( OR = 5.23, 95% CI = 1.05 ~ 26.08) 均与就诊延迟率增加呈正相关 ( P 值均<0.05)。 结论 东莞市青少年结核病防控工作亟需加强。应重点关注女性、 郊区、学生青少年结核病患者的就诊延迟问题, 制定合理的青少年结核病防控政策。