scholarly journals Factors Associated With Diagnostic Delay of Pulmonary Tuberculosis in China

2021 ◽  
Author(s):  
Caihong Xu ◽  
Xiaomeng Zhang ◽  
Yan Liu ◽  
Yinyin Xia ◽  
Li Wang ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Urban Areas ◽  
Clinical Symptoms ◽  
Public Awareness ◽  
Diagnostic Delay ◽  
Diagnosis Delay ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Major Barrier ◽  
Factors Associated

Abstract Background Tuberculosis (TB) is still a great challenge to public health in China. Most of the transmission occurs between the onset of symptoms and initiation of treatment. Diagnosis delay is a major barrier to effective management of the disease. Determining the factors associated with patient and provider delay of TB diagnosis and treatment may contribute to TB prevention and control.MethodsA cross-sectional survey of pulmonary tuberculosis registed in the National Tuberculosis programme was conducted in 22 counties of 6 provinces in China. All consecutively registered patients during January to June 2017 were interviewed using a structured questionnaire. The time from the onset of symptoms to the date of diagnosis was analyzed. Bivariate and logistics regression were applied to analyze the risk factors of delay.ResultsThe median time from onset of symptoms to diagnosis was 23 days (interquartile range [IQR]: 5-53days). The risk of delayed diagnosis was higher in the central (OR=3.27, 95%CI 1.39-7.68) and eastern regions (OR=1.48, 95%CI 1.04-2.10) than in the western regions. Rural TB patients have a longer diagnosis delay than those in urban areas (OR=1.44, 95%CI 1.00-2.08). The asymptomatic TB patients had a longer diagnosis delay than TB patients with clinical symptoms (OR=0.20, 95%CI 0.13-0.31).ConclusionsA high propotion of TB patients showed diagnostic delay in China especially in some low economic level areas. Multiple measures should be taken to shorten the delay, such as to increase public awareness of the disease and expansion the quality assured facility in economic less-developed regions.Trial registrationNot applicable

scholarly journals Gender and time delays in diagnosis of pulmonary tuberculosis: a cross-sectional study from China

2019 ◽  
Vol 147 ◽  
Author(s):  
H. G. Chen ◽  
T. W. Wang ◽  
Q. X. Cheng
Keyword(s):  
Gender Differences ◽  
Pulmonary Tuberculosis ◽  
Rural Areas ◽  
Diagnostic Delay ◽  
Cross Sectional Study ◽  
Diagnosis Delay ◽  
Sectional Study ◽  
Short Delay ◽  
Cross Sectional ◽  
Increased Risk

AbstractGender inequality has severe consequences on public health in terms of delay in diagnosis of pulmonary tuberculosis (PTB). In order to explore gender-related differences in diagnosis delay, a cross-sectional study of 10 686 patients diagnosed with PTB in Yulin from 1 January 2009 to 31 December 2014 was conducted. Diagnosis delay was categorised into ‘short delay’ and ‘long delay’ by four commonly used cut-off points of 14, 30, 60 and 90 days. Logistic regression analysis was used to analyse gender differences in diagnostic delay. Stratified analyses by smear results, age, urban/rural were performed to examine whether the effect persisted across the strata. The median delay was 31 days (interquartile range 13–65). Diagnostic delay in females at cut-off points of 14, 30, 60 and 90 days had odds ratios (OR) of 0.99 (95% CI 0.91–1.09), 1.09 (95% CI 1.01–1.18), 1.15 (95% CI 1.05–1.26) and 1.18 (95% CI 1.06–1.31), respectively, compared with males. Stratified analysis showed that females were associated with increased risk of longer delay among those aged 30–60 years, smear positive and living in the rural areas (P < 0.05). The female-to-male OR increased along with increased delay time. Further inquiry into the underlying reasons for gender differences should be urgently addressed to improve the current situation.

scholarly journals Delay in diagnosis of pulmonary tuberculosis increases the risk of pulmonary cavitation in pastoralist setting of Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Fentabil Getnet ◽  
Meaza Demissie ◽  
Alemayehu Worku ◽  
Tesfaye Gobena ◽  
Rea Tschopp ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Diagnosis Delay ◽  
Discriminative Ability ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Factors Associated ◽  
Record Review

Abstract Background Delay in diagnosis and treatment of pulmonary tuberculosis (PTB) leads to severe disease, adverse outcomes and increased transmission. Assessing the extent of delay and its effect on disease progression in TB affected settings has clinical and programmatic importance. Hence, the aim of this study was to investigate the possible effect of delay on infectiousness (cavitation and smear positivity) of patients at diagnosis in Somali pastoralist area, Ethiopia. Methods A cross-sectional study was conducted between December 2017 and October 2018, and 434 newly coming and confirmed PTB patients aged ≥15 years were recruited in five facilities. Data were collected using interview, record-review, anthropometry, Acid-fast bacilli and chest radiography techniques. Log-binomial regression models were used to reveal the association of delay and other factors associated with cavitation and smear positivity, and ROC Curve was used to determine discriminative ability and threshold delays. Results Median age of patients was 30 years. Of all, 62.9% were males, and 46.5% were pastoralists. Median diagnosis delay was 49 days (IQR = 33–70). Cavitation was significantly associated with diagnosis delay [P < 0.001]; 22.2% among patients diagnosed within 30 days of illness and 51.7% if delay was over 30 days. The threshold delay that optimizes cavitation was 43 days [AUC (95% CI) = 0.67(0.62–0.72)]. Smear positivity was significantly increased in patients delayed over 49 days [p = 0.02]. Other factors associated with cavitation were age ≤ 35 years [APR (95% CI) =1.3(1.01–1.6)], chronic diseases [APR (95% CI) = 1.8(1.2–2.6)] and low MUAC*female [APR (95% CI) = 1.8(1.2–2.8)]. Smear positivity was also associated with age ≤ 35 years [APR (95% CI) =1.4(1.1–1.8)], low BMI [APR (95% CI) =1.3(1.01–1.7)] and low MUAC [APR (95% CI) =1.5(1.2–1.9)]. Conclusion This study highlights delay in diagnosis of pulmonary TB remained high and increased infectiousness of patients in pastoral settings of Ethiopia. Hence, delay should be targeted to improve patient outcomes and reduce transmission in such settings.

A 2020 Update on Public Awareness of Head and Neck Cancers

2021 ◽  
pp. 019459982110069
Author(s):  
Sina J. Torabi ◽  
David A. Kasle ◽  
Brooke M. Su-Velez ◽  
Saral Mehra ◽  
Terry A. Day ◽  
...  
Keyword(s):  
Head And Neck ◽  
Public Awareness ◽  
Head And Neck Cancers ◽  
Older Individuals ◽  
Cancer Awareness ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
At Risk Populations

Objective To assess knowledge regarding head and neck cancers (HNCs) in 2020, factors associated with knowledge of the role of human papillomavirus (HPV) in HNCs, and factors associated with exposure to Oral, Head and Neck Cancer Awareness Week (OHANCAW). Study Design Cross-sectional survey. Setting Online. Methods The survey was distributed to 517 participants via a paid panel and utilized US Census–built quotas to represent the US population. Results Participants surpassed 50% awareness rates in only 5 of 10 (50.0%), 2 of 6 (33.3%), and 5 of 9 (55.5%) preselected answer choices for subsites, risk factors, and signs/symptoms of HNCs, respectively. Knowledge of HPV’s role in oropharyngeal cancer was also low, at 30.6%. However, of the controlled variables, exposure to OHANCAW was closely associated with knowledge of HPV’s role in HNC (odds ratio, 10.25; 95% CI, 5.36-19.62). Women and elderly individuals were less likely to be exposed to OHANCAW, while those with higher education, those who drink heavily (>4 drinks/d), and current but not former tobacco users were more likely to be exposed. Conclusions Knowledge of HNCs and the causal role of HPV remains suboptimal, though our results suggest that OHANCAW remains a viable educational pathway. However, certain at-risk populations, such as former smokers and older individuals, whom we may not be effectively reaching and screening, represent a priority for future outreach efforts.

Prevalence and socio-cultural determinants of domestic violence among married women in Thimphu, Bhutan

2015 ◽  
Vol 1 (1) ◽  
pp. 39-48 ◽  
Author(s):  
Kencho Wangmo
Keyword(s):  
Domestic Violence ◽  
Rural Areas ◽  
Urban Areas ◽  
Public Health Problem ◽  
Population Based ◽  
Married Women ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Adolescent Women

Introduction: Domestic violence is a public health problem all over the world, yet its prevalence is under-reported in a pervasive “culture of silence”. Bhutan is not likely to be an exception; however, data on the prevalence, forms and determinants of domestic violence are scant. The purpose of this study is to measure the prevalence and characterize factors associated with domestic violence among women in Thimphu, Bhutan’s capital. Methods: A population-based, household cross-sectional survey was conducted in January-May, 2012. A multistage sampling method was used to obtain a representative sample of 300 married women. The chi-square test was used to identify factors associated with increased likelihood of experiencing the four forms of domestic violence. Results: The overall prevalence of any domestic violence was 44%. By type of violence, the most common was emotional (36%), followed by control (30%), physical (20%) and sexual (14%). Sexual violence was reported more often by young adolescent women. Women from urban areas reported more emotional violence compared to women from rural areas. Women agreed with many situations in which force might be used by their husbands and with many of the traditional roles of women in society. Nonetheless, many women objected to the use of force in many situations and rejected certain constraining roles of women. Conclusions: This study supports the importance of advocacy for education and programs to prevent and mitigate harm from domestic abuse experienced by women in Bhutan.

scholarly journals Total, Patient and System Diagnostic Delays for Pulmonary Bacilliferous Tuberculosis in the Six Diagnostic and Treatment Centers in the Five Health Districts of the Central Region, Burkina Faso, 2018

2022 ◽  
Author(s):  
Pauline Kiswendsida Yanogo ◽  
Clarisse Balima ◽  
Nicolas Meda
Keyword(s):  
Pulmonary Tuberculosis ◽  
Burkina Faso ◽  
Central Region ◽  
Diagnostic Delay ◽  
Cross Sectional Study ◽  
Diagnosis Delay ◽  
Cross Sectional ◽  
Total Patient ◽  
Number Of Patients ◽  
Health Districts

Abstract Introduction Long diagnosis delay contributes significantly to the failure to eradicate tuberculosis. The objective of this study was to evaluate the total, patient and system delays in diagnosis of pulmonary bacilliferous in the six tuberculosis Diagnostic and Treatment Centers in the five health districts of the central region in Burkina Faso. Methods A descriptive cross-sectional study was conducted among 384 microscopy-positive pulmonary tuberculosis patients in 2018 to address this objective. It concerned the socio-demographic, clinical, microbiological characteristics, and referral location/pathway characteristics of the patients. We then calculated the different delays. The “patient” (time from first symptoms to first consultation), “system” (time from first consultation to first diagnosis) and total (time from first symptoms to diagnosis) median diagnostic delay were estimated. Results The median “total”, “patient” and “system” diagnostic times were 37, 21 and 7 days, respectively. Of the 384 patients surveyed, 158 patients or 41.25% of patients had a long total diagnostic delay (> 45 days). The number of patients with a long system diagnostic delay was 125 patients (32.55%; p < 0.001) and those with a long patient diagnostic delay were 105 patients (27.34%; p < 0.001). Conclusion The total diagnosis delay of pulmonary tuberculosis was long for almost half of the patients. Awareness of the signs of tuberculosis among patients and caregivers, and consultation in a health center must be intensified to help considerably reduce these delays.

Prevalence and determinant factors of exclusive breastfeeding practices among mothers in Marrakesh province, Morocco: A cross- sectional survey

2021 ◽  
pp. 1-11
Author(s):  
Soufiane El Moussaoui ◽  
Kamal Kaoutar ◽  
Ahmed Chetoui ◽  
Abdeslam El Kardoudi ◽  
Fatiha Chigr ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Multivariate Logistic Regression ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Breastfeeding Practices ◽  
Survey Report ◽  
Duration Of Breastfeeding ◽  
Breastfeeding Practice

BACKGROUND: Exclusive breastfeeding is the best form of nutrition for infants during the first 6 months of life. Nevertheless, the practice of breastfeeding is currently declining throughout the world. OBJECTIVE: The objective of this study was to assess the prevalence of exclusive breastfeeding (EBF) practice and its associated factors among mothers living in Marrakesh province, Morocco. METHODS: The data were collected using an interviewer administered questionnaire. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with exclusive breastfeeding practice. RESULTS: Prevalence of exclusive breastfeeding was 50.2%. Mothers with age more than 30 years, residing in rural area, receiving counseling related breastfeeding during antenatal follow up and having knowledge about duration of breastfeeding were more likely to practice exclusive breastfeeding than their counterparts. CONCLUSION: Although the prevalence of breastfeeding in Marrakesh was higher than the last national survey report but it is still insufficient. These findings have to stress authorities and deciders to sensitize mothers and future mothers to increase exclusive breastfeeding practice notably through the involvement of health professionals.

scholarly journals Acute food insecurity and short-term coping strategies of urban and rural households of Bangladesh during the lockdown period of COVID-19 pandemic of 2020: report of a cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e043365
Author(s):  
Subhasish Das ◽  
Md. Golam Rasul ◽  
Md Shabab Hossain ◽  
Ar-Rafi Khan ◽  
Md Ashraful Alam ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Coping Strategies ◽  
Rural Areas ◽  
Urban Areas ◽  
Multinomial Logistic Regression ◽  
Rural Households ◽  
P Value ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Food Insecure Households

IntroductionWe conducted a cross-sectional survey to assess the extent and to identify the determinants of food insecurity and coping strategies in urban and rural households of Bangladesh during the month-long, COVID-19 lockdown period.SettingSelected urban and rural areas of Bangladesh.Participants106 urban and 106 rural households.Outcome variables and methodHousehold food insecurity status and the types of coping strategies were the outcome variables for the analyses. Multinomial logistic regression analyses were done to identify the determinants.ResultsWe found that around 90% of the households were suffering from different grades of food insecurity. Severe food insecurity was higher in urban (42%) than rural (15%) households. The rural households with mild/moderate food insecurity adopted either financial (27%) or both financial and food compromised (32%) coping strategies, but 61% of urban mild/moderate food insecure households applied both forms of coping strategies. Similarly, nearly 90% of severely food insecure households implemented both types of coping strategies. Living in poorest households was significantly associated (p value <0.05) with mild/moderate (regression coefficient, β: 15.13, 95% CI 14.43 to 15.82), and severe food insecurity (β: 16.28, 95% CI 15.58 to 16.97). The statistically significant (p <0.05) determinants of both food compromised and financial coping strategies were living in urban areas (β: 1.8, 95% CI 0.44 to 3.09), living in poorest (β: 2.7, 95% CI 1 to 4.45), poorer (β: 2.6, 95% CI 0.75 to 4.4) and even in the richer (β: 1.6, 95% CI 0.2 to 2.9) households and age of the respondent (β: 0.1, 95% CI 0.02 to 0.21).ConclusionBoth urban and rural households suffered from moderate to severe food insecurity during the month-long lockdown period in Bangladesh. But, poorest, poorer and even the richer households adopted different coping strategies that might result in long-term economic and nutritional consequences.

scholarly journals Assessing Factors Associated with TB Awareness in Nepal: A National and Subnational Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5124
Author(s):  
Yoko Iwaki ◽  
Santosh Kumar Rauniyar ◽  
Shuhei Nomura ◽  
Michael C. Huang
Keyword(s):  
Socioeconomic Factors ◽  
Influential Factors ◽  
Regional Level ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Information And Communication ◽  
High Level

Tuberculosis (TB) has still remained a serious global health threat in low- and middle-income countries in recent years. As of 2021, Nepal is one of the high TB burden countries, with an increasing prevalence of cases. This study evaluates factors associated with TB awareness in Nepal. This study uses data from the Nepal Demographic and Health Survey, a cross-sectional survey carried out from June 2016 to January 2017. Multilevel logistic regression is performed to examine the association of demographic and socioeconomic factors with TB awareness. Our findings show a high level of TB awareness in all seven provinces of Nepal. Province 5 has the highest level of awareness (98.1%) among all provinces, followed by provinces 3 and 4, while province 6 has the lowest awareness level (93.2%) compared to others. Socioeconomic factors such as wealth, education and owning a mobile phone are significantly associated with TB awareness. Socioeconomic determinants are influential factors associated with TB awareness in Nepal. The wide variation in the proportion of awareness at a regional level emphasizes the importance of formulating tailored strategies to increase TB awareness. For instance, the use of mobile phones could be an effective strategy to promote TB awareness at a regional level. This study provides valuable evidence to support further research on the contribution of information and communication technology (ICT) usage to improving TB awareness in Nepal.

scholarly journals Utilization of denture adhesives and the factors associated with its use: a cross-sectional survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tun Min Bo ◽  
Yohei Hama ◽  
Norihisa Akiba ◽  
Shunsuke Minakuchi
Keyword(s):  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Denture Adhesives

scholarly journals Career Intentions and Dropout Causes Among Medical Students in Kazakhstan

Medicina ◽  
2013 ◽  
Vol 49 (6) ◽  
pp. 45
Author(s):  
Kamila Faizullina ◽  
Galina Kausova ◽  
Zhanna Kalmataeva ◽  
Ardak Nurbakyt ◽  
Saule Buzdaeva
Keyword(s):  
Medical Students ◽  
Human Resources ◽  
Rural Areas ◽  
Urban Areas ◽  
Human Resources For Health ◽  
Medical Schools ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Unequal Distribution ◽  
Survey Tool

Background and Objective. The number of new entrants to higher medical schools of Kazakhstan increased by 1.6 times from 2007 to 2012. However, it is not known how it will affect the shortage of human resources for health. Additionally, human resources for health in rural areas of Kazakhstan are 4 times scarcer than in urban areas. The aim of the present study was to investigate the intentions of students toward their professional future and readiness to work in rural areas, as well as to determine the causes for dropping out from medical schools. Material and Methods. A cross-sectional survey was conducted in 2 medical universities in Almaty during the academic year 2011–2012. The study sample included medical students and interns. In total, 2388 students participated in the survey. The survey tool was an anonymous questionnaire. Results. The students of the first years of studies compared with those of later years of studies were more optimistic about the profession and had more intentions to work in the medical field. Only 8% of the students reported a wish to work in rural localities. On the other hand, 4% of the students did not plan to pursue the profession. On the average, every third medical student dropped out on his/her own request. Conclusions. Associations between intentions to work according to the profession and the year of studies, faculty, and residence area before enrolling in a medical school were documented. The majority of the students who came from rural areas preferred to stay and look for work in a city, which might contribute to an unequal distribution of physicians across the country.

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