PDF(Pubmed)
Abstract：
UNASSIGNED: There is a lack of research evidence on the quantitative relationship between symptom burden and health care seeking among individuals with presumptive tuberculosis (TB).
UNASSIGNED: Data were derived from a cross-sectional population-based TB survey conducted between February 2021 and July 2022 in 32 districts of India. Eligible and consented participants (age >15 years) underwent TB symptom screening and history elicitation. Fairlie decomposition analysis was used to estimate the net differences in health care seeking due to varied symptom burden-from 1+ burden (>1 symptom) to 4+ burden (>4 symptoms)-and decomposed by observable covariates based on logit models with 95% CIs.
UNASSIGNED: Of the 130 932 individuals surveyed, 9540 (7.3%) reported at least 1 recent TB symptom, of whom 2678 (28.1%; 95% CI, 27.1%-28.9%) reportedly sought health care. The net differences in health care seeking among persons with symptom burden 1+ to 4+ ranged from 6.6 percentage points (95% CI, 4.8-8.4) to 7.7 (95% CI, 5.2-10.2) as compared with persons with less symptom burden. The presence of expectoration, fatigue, and loss of appetite largely explained health care seeking (range, 0.9-3.1 percentage points [42.89%-151.9%]). The presence of fever, cough, past TB care seeking, weight loss, and chest pain moderately explained (range, 5.3%-25.3%) health care seeking.
UNASSIGNED: Increased symptom burden and symptoms other than the commonly emphasized cough and fever largely explained health care seeking. Orienting TB awareness and risk communications toward symptom burden and illness perceptions could help address population gaps in health care seeking for TB.
UNASSIGNED: Data were derived from a cross-sectional population-based TB survey conducted between February 2021 and July 2022 in 32 districts of India. Eligible and consented participants (age >15 years) underwent TB symptom screening and history elicitation. Fairlie decomposition analysis was used to estimate the net differences in health care seeking due to varied symptom burden-from 1+ burden (>1 symptom) to 4+ burden (>4 symptoms)-and decomposed by observable covariates based on logit models with 95% CIs.
UNASSIGNED: Of the 130 932 individuals surveyed, 9540 (7.3%) reported at least 1 recent TB symptom, of whom 2678 (28.1%; 95% CI, 27.1%-28.9%) reportedly sought health care. The net differences in health care seeking among persons with symptom burden 1+ to 4+ ranged from 6.6 percentage points (95% CI, 4.8-8.4) to 7.7 (95% CI, 5.2-10.2) as compared with persons with less symptom burden. The presence of expectoration, fatigue, and loss of appetite largely explained health care seeking (range, 0.9-3.1 percentage points [42.89%-151.9%]). The presence of fever, cough, past TB care seeking, weight loss, and chest pain moderately explained (range, 5.3%-25.3%) health care seeking.
UNASSIGNED: Increased symptom burden and symptoms other than the commonly emphasized cough and fever largely explained health care seeking. Orienting TB awareness and risk communications toward symptom burden and illness perceptions could help address population gaps in health care seeking for TB.
摘要：
■目前缺乏关于结核病（TB）患者的症状负担与寻求医疗保健之间的定量关系的研究证据。
■数据来自2021年2月至2022年7月在印度32个地区进行的基于人群的横断面结核病调查。符合条件并同意的参与者（年龄>15岁）接受了TB症状筛查和病史激发。Fairlie分解分析用于估计由于症状负担从1负担（>1症状）到4负担（>4症状）不同而导致的寻求医疗保健的净差异，并根据具有95％CIs的logit模型通过可观察的协变量进行分解。
■在接受调查的130932人中，9540（7.3％）报告了至少一种近期结核病症状，据报道，其中2678人（28.1%；95%CI，27.1%-28.9%）寻求医疗保健。与症状负担较小的人相比，症状负担为1至4的人寻求医疗保健的净差异为6.6个百分点（95％CI，4.8-8.4）至7.7（95％CI，5.2-10.2）。咳痰的存在，疲劳,和食欲不振在很大程度上解释了寻求医疗保健(范围，0.9-3.1个百分点[42.89%-151.9%]）。发烧的存在，咳嗽,过去寻求结核病护理，减肥,和适度解释的胸痛(范围，5.3%-25.3%）就医。
■除通常强调的咳嗽和发烧外，症状负担和症状增加在很大程度上解释了寻求医疗保健的原因。将结核病意识和风险沟通导向症状负担和疾病认知，可以帮助解决在寻求结核病的医疗保健方面的人口差距。
■数据来自2021年2月至2022年7月在印度32个地区进行的基于人群的横断面结核病调查。符合条件并同意的参与者（年龄>15岁）接受了TB症状筛查和病史激发。Fairlie分解分析用于估计由于症状负担从1负担（>1症状）到4负担（>4症状）不同而导致的寻求医疗保健的净差异，并根据具有95％CIs的logit模型通过可观察的协变量进行分解。
■在接受调查的130932人中，9540（7.3％）报告了至少一种近期结核病症状，据报道，其中2678人（28.1%；95%CI，27.1%-28.9%）寻求医疗保健。与症状负担较小的人相比，症状负担为1至4的人寻求医疗保健的净差异为6.6个百分点（95％CI，4.8-8.4）至7.7（95％CI，5.2-10.2）。咳痰的存在，疲劳,和食欲不振在很大程度上解释了寻求医疗保健(范围，0.9-3.1个百分点[42.89%-151.9%]）。发烧的存在，咳嗽,过去寻求结核病护理，减肥,和适度解释的胸痛(范围，5.3%-25.3%）就医。
■除通常强调的咳嗽和发烧外，症状负担和症状增加在很大程度上解释了寻求医疗保健的原因。将结核病意识和风险沟通导向症状负担和疾病认知，可以帮助解决在寻求结核病的医疗保健方面的人口差距。
