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Delayed diagnosis of tuberculosis in patients with diabetes mellitus co-morbidity and its associated factors in Zhejiang Province, China

机译:延迟诊断糖尿病患者结核病患者,浙江省浙江省浙江省副病症及其相关因素

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Tuberculosis (TB) remains a significant global public health problem. China has the second highest TB burden in the world. With a growing TB population with diabetes mellitus (DM), the TB control system faces mounting challenges. To date, evidence remains inconclusive regarding the association between TB-DM co-morbidity and delayed diagnosis of TB patients. This study aims to assess the diagnostic delay of TB patients with known DM and identify the factors associated with this delay. Data was collected from China’s Tuberculosis information management system in two counties of Zhejiang province, China. Patient delay, health system delay and total diagnostic delay are defined as follows: 1) the interval between the onset of TB symptoms and first visit to any health facility; 2) from the first visit to the health facility to the confirmed TB diagnosis in the designated hospital; 3) the sum of patient and health system’s respective delays. Comparison of these delays was made between TB patients with and without DM using Mann-Whitney U test and Chi-square test. Univariate and multivariate regression analysis was used to identify factors influencing delays among TB patients with DM. Of 969?TB patients, 67 (7%) TB patients had DM co-morbidity. Compared with TB patients without DM, TB patients with DM experienced significantly shorter health system delays (p 14?days (7.0% vs. 18%, p 14?days. Our study suggests that DM does not contribute to further diagnostic delay as expected. Instead, we observed significantly improved health system delay among TB patients with DM. The findings indicate the importance of early screening and diagnosis for TB among diabetic patients and of strengthening the integrated control and management of TB and diabetic programs.
机译:结核病(TB)仍然是一个重要的全球公共卫生问题。中国拥有世界上第二大的TB负担。随着患有糖尿病(DM)的TB人口,TB控制系统面向安装挑战。迄今为止,有关TB-DM持续发病率和TB患者延迟诊断的关联仍然不确定。本研究旨在评估已知DM的结核病患者的诊断延迟,并确定与此延迟相关的因素。中国浙江省两县的中国结核信息管理系统收集了数据。患者延迟,卫生系统延迟和总诊断延迟定义如下:1)结核病症状的发作和第一次访问任何卫生设施之间的间隔; 2)从第一次访问卫生机构到指定医院的确认结核病诊断; 3)患者和卫生系统的总和的各自延误。通过使用Mann-Whitney U测试和Chi-Square测试,在TB患者与无DM之间进行了这些延迟的比较。单变量和多元回归分析用于识别影响DM患者延迟的因素。在969例患者中,67例(7%)TB患者具有DM共发病率。与没有DM的TB患者相比,DM的TB患者经历了较短的卫生系统延误(P 14?天(7.0%与18%,P 14.日,我们的研究表明DM没有促进进一步的诊断延误。相反,我们观察到DM患者的TB患者之间的卫生系统延迟显着提高。该研究结果表明糖尿病患者中TB的早期筛查和诊断的重要性以及加强TB和糖尿病课程的综合控制和管理。

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