Dataset Information

Pulmonary tuberculosis among migrants in Shandong, China: factors associated with treatment delay.

ABSTRACT:

Objective

A timely initiation of treatment is crucial to better control tuberculosis (TB). The aim of this study is to describe treatment delay among migrant patients with TB and to identify factors associated with treatment delay, so as to provide evidence for strategy development and improvement of TB control among migrants in China.

Design

A cross-sectional study was conducted in Shandong province of China. A total of 314 confirmed smear positive migrant patients with pulmonary TB were included. Univariate logistic regression was used to analyse the association of variables with treatment delay among migrant patients with TB. A multilogistic regression model was developed to further assess the effect of variables on treatment delay.

Results

Of 314 migrant patients with TB, 65.6% experienced treatment delay (>1 day). Household income level, diagnosis symptom severity, understanding of whether TB is curable or not and knowledge about the free TB treatment policy are factors significantly associated with treatment delay.

Conclusions

Economic status and knowledge about TB are key barriers to accessing TB treatment. An integrated policy of carrying out TB-related health education and publicising the free TB treatment policy among migrants is needed. Health insurance schemes for migrants should be modified to make them transferrable and pro-poor.

SUBMITTER: Zhou C

PROVIDER: S-EPMC4275669 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Publications

Pulmonary tuberculosis among migrants in Shandong, China: factors associated with treatment delay.

Zhou Chengchao C Chu Jie J Geng Hong H Wang Xingzhou X Xu Lingzhong L

BMJ open 20141222 12

<h4>Objective</h4>A timely initiation of treatment is crucial to better control tuberculosis (TB). The aim of this study is to describe treatment delay among migrant patients with TB and to identify factors associated with treatment delay, so as to provide evidence for strategy development and improvement of TB control among migrants in China.<h4>Design</h4>A cross-sectional study was conducted in Shandong province of China. A total of 314 confirmed smear positive migrant patients with pulmonary ...[more]

PMID: 25534210

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Project description:BACKGROUND:Pulmonary tuberculosis (PTB,both smear positive and smear negative) is an airborne infectious disease of major public health concern in China and other parts of the world where PTB endemicity is reported. This study aims at identifying PTB spatio-temporal clusters and associated risk factors in Zhaotong prefecture-level city, located in southwest China, where the PTB notification rate was higher than the average rate in the entire country. METHODS:Space-time scan statistics were carried out using PTB registered data in the nationwide TB online registration system from 2011 to 2015, to identify spatial clusters. PTB patients diagnosed between October 2015 and February 2016 were selected and a structured questionnaire was administered to collect a set of variables that includes socio-economic status, behavioural characteristics, local environmental and biological characteristics. Based on the discovery of detailed town-level spatio-temporal PTB clusters, we divided selected subjects into two groups including the cases that resides within and outside identified clusters. Then, logistic regression analysis was applied comparing the results of variables between the two groups. RESULTS:A total of 1508 subjects consented and participated in the survey. Clusters for PTB cases were identified in 38 towns distributed over south-western Zhaotong. Logistic regression analysis showed that history of chronic bronchitis (OR = 3.683, 95% CI: 2.180-6.223), living in an urban area (OR = 5.876, 95% CI: 2.381-14.502) and using coal as the main fuel (OR = 9.356, 95% CI: 5.620-15.576) were independently associated with clustering. While, not smoking (OR = 0.340, 95% CI: 0.137-0.843) is the protection factor of spatial clustering. CONCLUSIONS:We found PTB specially clustered in south-western Zhaotong. The strong associated factors influencing the PTB spatial cluster including: the history of chronic bronchitis, living in the urban area, smoking and the use of coal as the main fuel for cooking and heating. Therefore, efforts should be made to curtail these associated factors.

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Dataset Information

Pulmonary tuberculosis among migrants in Shandong, China: factors associated with treatment delay.

Objective

Design

Results

Conclusions

Publications

Pulmonary tuberculosis among migrants in Shandong, China: factors associated with treatment delay.

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