Abstract：
BACKGROUND Engaging private health providers and community healthcare workers (CHWs) in the provision of TB care services can increase TB case notification and limit community transmission. We determined whether private pharmacy and community engagement could affect access to TB diagnostic and treatment services in Uganda.METHODS We conducted a cross-sectional study on patients diagnosed with TB through three different pathways; by private pharmacies, CHWs, and public health facilities. We collected data on patient demographics, time between symptom recognition and TB treatment initiation, and the amount of money spent on TB care seeking.RESULTS We collected data from 325 participants; 65.2% were male, with a mean age of 35 years (SD 11.50). The time in days between the onset of symptoms and initiation of treatment was significantly different: respectively 149 (IQR 65.5-295), 119 (IQR 51-200), and 106.5 (IQR 60-201) days for CHWs, pharmacies, and public facilities (P = 0.04). The longest time was between the first contact with a health provider and the TB diagnosis (51 days, IQR 19-104). Participants diagnosed at public health facilities incurred the highest costs.CONCLUSION Although the use of CHWs and pharmacies did not shorten the TB treatment pathway, the costs incurred were lower than those in private health facilities.
摘要：
背景 让私人医疗服务提供者和社区医护人员（CHW）参与提供结核病护理服务可以增加结核病病例通知并限制社区传播。我们确定了私人药房和社区参与是否会影响乌干达获得结核病诊断和治疗服务。方法 我们对通过三种不同途径诊断为结核病的患者进行了横断面研究；通过私人药房，CHWs,和公共卫生设施。我们收集了病人的人口统计数据,症状识别和结核病治疗开始之间的时间，以及用于寻求结核病治疗的金额。结果 我们收集了325名参与者的数据；65.2％为男性，平均年龄35岁（SD11.50）。症状发作和开始治疗之间的天数显着不同：分别为149（IQR65.5-295），119（IQR51-200），CHW的106.5(IQR60-201)天，药店,公共设施（P=0.04）。最长的时间是与健康提供者的第一次接触和结核病诊断之间(51天，IQR19-104).在公共卫生机构诊断的参与者费用最高。结论 尽管使用CHW和药房并未缩短结核病治疗途径，发生的费用低于私营医疗机构的费用。
