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埃塞俄比亚肺结核患者的肺结核治疗延迟及相关影响因素:一项系统评价与荟萃分析

Tuberculosis treatment delay and contributing factors within tuberculosis patients in Ethiopia: A systematic review and meta-analysis.

作者信息

Fetensa Getahun, Wirtu Dessalegn, Etana Belachew, Wakuma Bizuneh, Tolossa Tadesse, Gugsa Jilcha, Gobena Dabesa, Fekadu Ginenus, Ragasa Misganu Teshoma, Ejeta Eshetu

机构信息

Department of Nursing, School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.

Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.

出版信息

Heliyon. 2024 Mar 23;10(7):e28699. doi: 10.1016/j.heliyon.2024.e28699. eCollection 2024 Apr 15.

Abstract

BACKGROUND

Tuberculosis (TB) is a significant public health disease and a major contributor to illness and death worldwide, including in Ethiopia. There are many information from first source which had inconclusive result in Ethiopia. Therefore, this review aimed to produce pooled evidence on the TB treatment delay and factors associated with it.

METHODS

The absence of a similar study with a systematic review and meta-analysis was confirmed. Articles from online available and unpublished sources conducted within Ethiopia between 2002 and 2024, were thoroughly screened using electronic sources such as Medline, Embase, Hinari, PubMed, the Cochrane Library, the Web of Science, and Google Scholar. Data analysis was performed using STATA version 14. Heterogeneity was assessed using Inverse of Variance (I) and Cochrane Q tests. The funnel plot was employed to rule existence of publications subjectively while bias was checked using Egger's statistical method to quantify the bias.

RESULT

Prevalence of TB treatment delay in Ethiopia was 50.42% at 95% (43.21, 57.64). Factors such as knowledge about TB, distance to health facilities less than 10 km, initial contact at a government service providing center for TB, having some educations, having pulmonary Tuberculosis, urban residency, were prtotective towards treatment delay. Female in gender, no chest pain symptom, disease severity with no restriction on daily activity, alcohol drinkers, and unmarried respondents were at higher risk to miss on time tuberculosis treatment.

CONCLUSION AND RECOMMENDATION

The tuberculosis treatment delay in Ethiopia was considerably unexpected and basic personal variables and facility related variables were statistically associated with treatment. Therefore, Ethiopian TB control programs have to recognize and tackle the problem, obstacles, and vulnerability across the continuum patient care taking down and connecting to treatment post-diagnosis. This can be achieved by capacitating both government and non-governmental service provision centers and minimizing unfilled difference across professional awareness and skill, which will contribute further to minimizing delay.

摘要

背景

结核病是一种严重的公共卫生疾病,是全球疾病和死亡的主要原因之一,包括在埃塞俄比亚。在埃塞俄比亚,有许多来自第一手资料的信息,其结果尚无定论。因此,本综述旨在提供关于结核病治疗延迟及其相关因素的汇总证据。

方法

确认没有类似的系统评价和荟萃分析研究。使用电子资源,如Medline、Embase、Hinari、PubMed、Cochrane图书馆、科学网和谷歌学术,对2002年至2024年在埃塞俄比亚境内开展的在线可用和未发表来源的文章进行了全面筛选。使用STATA 14版进行数据分析。使用方差倒数(I)和Cochrane Q检验评估异质性。采用漏斗图主观判断出版物的存在情况,同时使用Egger统计方法检查偏倚以量化偏倚。

结果

埃塞俄比亚结核病治疗延迟的患病率为50.42%,95%置信区间为(43.21,57.64)。对结核病的了解、距离医疗机构小于10公里、在政府结核病服务提供中心首次接触、接受过一定教育、患有肺结核、城市居住等因素对治疗延迟具有保护作用。女性、无胸痛症状、疾病严重程度但日常活动无限制、饮酒者和未婚受访者错过结核病及时治疗的风险较高。

结论与建议

埃塞俄比亚的结核病治疗延迟情况相当出人意料,基本的个人变量和设施相关变量与治疗在统计学上相关。因此,埃塞俄比亚的结核病控制项目必须认识并解决整个患者护理过程中的问题、障碍和脆弱性,包括诊断后开始并连接到治疗。这可以通过增强政府和非政府服务提供中心的能力以及尽量减少专业意识和技能方面未填补的差距来实现,这将有助于进一步减少延迟。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f39/10998239/f3560a2745cd/gr1.jpg

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