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目的了解上海市普陀区非户籍人口结核病诊断延误情况,分析影响非户籍人口结核病诊断延误的人口学和社会经济学因素。方法对146例新确诊的非户籍人口结核病患者,采用回顾性队列研究方法了解患者延误、医生延误及诊断延误的时间,分析其影响因素。结果患者延误时间的中位数是19(7-33．5)天,医生延误时间的中位数是5(2．5-10)天,患者延误时间是医生延误时间的3．8倍。诊断延误时间的中位数是31(11-59)天,女性比男性发生诊断延误的危险性高(OR= 3．226,P<0．05);年收入<5000元者比≥10 000元者发生诊断延误的危险性高(OR=11．958,P< 0．01);痰涂片阴性者发生诊断延误的危险性低于阳性者(OR=0．280,P<0．05)。结论患者延误是诊断延误的主要部分,非户籍人口中女性、低文化程度的结核病患者其医疗可及性更容易受到影响。
Objective To understand the delay of diagnosis of tuberculosis in non-household population in Putuo District of Shanghai and to analyze the demographic and socio-economic factors affecting the delay of diagnosis of tuberculosis in non-registered population. Methods A retrospective cohort study was conducted on 146 newly diagnosed TB patients with non-registered population. The patients’ delay, the delay of doctors and the time of diagnosis were analyzed, and the influencing factors were analyzed. Results The median delay was 19 (7-33.5) days, the median delay was 5 (2.5-10) days and the delay was 3.8 times longer than the doctor delayed. The median delay in diagnosis was 31 (11-59) days, with a higher risk of delayed diagnosis than men (OR = 3.226, P <0.05); annual income of <5000 was ≥10 000 (OR = 11.958, P <0.01). The risk of delayed diagnosis of smear-negative patients was lower than that of positive ones (OR = 0.280, P <0.05) ). Conclusions Patient delays are a major part of the delay in diagnosis, and women’s access to medical care is more likely to be affected in women with non-registered population and people with a lower education level of TB.