Comprehensive understanding of health-seeking behaviour among pulmonary tuberculosis patients in China

作者：Jiang, Y.; Cao, B.; Ohmagari, N.; Wu, A-H.; Liu, Y-X.; Guo, L-P.^*

来源：International Journal of Tuberculosis and Lung Disease, 2017, 21(10): 1094-1099.

DOI：10.5588/ijtld.17.0227

• first-visited health facility
• health care visits
• Mycobacterium tuberculosis complex
• infection control
• transmission

SETTING: In China, there were 918 000 tuberculosis (TB) cases in 2015 alone. The primary challenge facing TB control is the allocation of limited health care resources. @@@ OBJECTIVE: To gain a comprehensive understanding of the first choice of health care facility among Chinese patients with suspected pulmonary TB (PTB) and the number of visits required to make the diagnosis. @@@ DESIGN: Relevant full-text articles in three Chinese and one English literature databases up to November 2016 were reviewed. Meta-analyses were performed using Stata v12.0. @@@ RESULTS: Among 1257 potentially relevant selected articles, 27 cross-sectional studies involving 9891 patients were included in the final analyses. Most PTB patients chose county-level hospitals (40%, 95 %CI-3346) and village clinics (34%, 95%CI 27-42); only 13% (95 %CI 10-16) of patients chose to visit PTB dispensaries first. Before obtaining the correct diagnosis, 28% (95 %CI 11-44) of patients had to visit health facilities more than three times. @@@ CONCLUSION: Patients with suspicion of PTB were more likely to visit low-level facilities than dispensaries. Repeated visits resulted in both overall delay and high risk of PTB transmission. These findings suggest that a shift in government policy for PTB is required.

• 出版日期2017-10
• 单位中日友好医院; 中国人民解放军总医院; 北京中医药大学; 首都医科大学; 中南大学