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| 1 | Diagnostic delay and associated factors among patients with pulmonary tuberculosis in Dar es Salaam,Tanzania显示文摘Background:Tanzania is among the 30 countries with the highest tuberculosis(TB)burdens.Because TB has a long infectious period,early diagnosis is not only important for reducing transmission,but also for improving treatment outcomes.We assessed diagnostic delay and associated factors among infectious TB patients.Methods:We interviewed new smear-positive adult pulmonary TB patients enrolled in an ongoing TB cohort study in Dar es Salaam,Tanzania,between November 2013 and June 2015.TB patients were interviewed to collect information on socio-demographics,socio-economic status,health-seeking behaviour,and residential geocodes.We categorized diagnostic delay into≤3 or>3 weeks.We used logistic regression models to identify risk factors for diagnostic delay,presented as crude(OR)and adjusted Odds Ratios(aOR).We also assessed association between geographical distance(incremental increase of 500 meters between household and the nearest pharmacy)with binary outcomes.Results:We analysed 513 patients with a median age of 34 years(interquartile range 27-41);353(69%)were men.Overall,444(87%)reported seeking care from health care providers prior to TB diagnosis,of whom 211(48%)sought care>2 times.Only six(1%)visited traditional healers before TB diagnosis.Diagnostic delay was positively associated with absence of chest pain(aOR=7.97,95%confidence intervals[CI]:3.15-20.19;P<0.001),and presence of hemoptysis(aOR=25.37,95%CI:11.15-57.74;P<0.001)and negatively associated with use of medication prior to TB diagnosis(aOR=0.31,95%CI:0.14-0.71;P=0.01).Age,sex,HIV status,education level,household income,and visiting health care facilities(HCFs)were not associated with diagnostic delay.Patients living far from pharmacies were less likely to visit a HCF(incremental increase of distance versus visit to any facility:OR=0.51,95%CI:0.28-0.96;P=0.037).Conclusions:TB diagnostic delay was common in Dar es Salaam,and was more likely among patients without prior use of medication and presenting with hemoptysis.Geographical distance to HCFs may have an impact on health-seeking behaviour.Increasing community awareness of TB signs and symptoms could further reduce diagnostic delays and interrupt TB transmission. | Khadija Said Jerry Hella Grace Mhalu Mary Chiryankubi Edward Masika Thomas Maroa Francis Mhimbira Neema Kapalata Lukas Fenner | 2017 | Infectious Diseases of Poverty2017，6，1： | 4 |
| 2 | Including transformation products into the risk assessment for chemicals: the case of nonylphenol ethoxylate usage in Switzerland 显示文摘 | FENNER K KOOIJMAN C SCHERINGEr M | 2002 | Environmental Science and Technology2002，26，： | 1 |
| 3 | Prediction of overall persistence and long-range transport potential with multimedia fate models : Robustness and sensitivity of results显示文摘 | Fenner K Scheringer M Hungerbuhler K | 2004 | Environmental Pollution2004，128，1： | 1 |
| 4 | Role of endogenous retroviruses as mutagens: the hairless mutation of mice显示文摘 | Stoye JP Fenner S | 1988 | Cell1988，54，3： | 1 |
| 5 | The challenge of micropollutants in aquatic systems 显示文摘 | Sehwarzenbach R P Escher B I Fenner K | 2006 | Science2006，313，5790： | 1 |
| 6 | Analysis of a four-bar mechanism with a radially compliant clearance joint显示文摘 | SENEVIRATNE L D EARLES S W E FENNER DN | 1996 | Proceedings of the Institution of Mechanical Engineers:Part C Journal of Mechanical Engineering Science1996，210，3： | 1 |
| 7 | The challenge of micropollutants in aquatic systems显示文摘 | SCHWARZENBACH R P ESCHER B FENNER K HOFSTETTER T B JOHNSON C A GUNTEN U V WEHRLI B | 2006 | Science2006，313，8： | 1 |
| 8 | Effects of interfi- her spacing and matrix cracks on stress amplification factors in carbon fiber/epoxy matrix composites part 2:Hexagonal array of fiber显示文摘 | Sirivedin S Fenner D N Nath R B | 2006 | Composites A2006，37，11： | 1 |
| 9 | The challenge of micropollutants in aquatic systems显示文摘 | SCHWARZENBACH R P ESCHER B I FENNER K | 2006 | Science2006，313，5790： | 1 |
| 10 | X-ray image intensitiers : image quality and possibilities for enhancement 显示文摘 | FENNER E FRANZ F GUDDEN F | 1972 | Advances in Electron and Electronic Physics1972，，： | 1 |
| 11 | Comparison of levator ani mus- cle defects and function in women with and without pelvic organ prolapse 显示文摘 | DeLancey JO Morgan DM Fenner DE | 2007 | Obstet Gynecol2007，109，21： | 1 |
| 12 | Chemotherapy for breast cancer brain metastases显示文摘 | Fenner MH Possinger K | 2002 | Onkologie2002，25，5： | 1 |
| 13 | Be aware of the possibility of false-positive results in single-locus PCR assays for methicillin-resistant Staphylococcus aureus 显示文摘 | RUPP J FENNER I SOLBACH W | 2006 | J Clin Microbiol2006，44，6： | 1 |
| 14 | Coral and crutose coralline algae disease on the reefs of American Samoa显示文摘 | AEBY G WORK T FENNER D | 2008 | Proceeding of the 11^th International Coral Reef Symposium2008，3，： | 1 |
| 15 | Indications for immediate loading of implants and implant success 显示文摘 | Nkenke E Fenner M | 2006 | C lin Oral Implants Res2006，17，2： | 1 |
| 16 | The challenge of micropollutants in aquatic systems显示文摘 | Schwarzenbach R P Escher B I Fenner K | 2006 | Science2006，313，5790： | 1 |
| 17 | Suppressor of cytokine signaling 1 regulates the immune response to infection by a unique inhibition of type I interferon activity显示文摘 | Fenner J E Starr R Cornish A L | 2006 | Nature Immunology2006，7，1： | 1 |
| 18 | Fecal and urinary incontinence after vaginal delivery with anal sphincter disruption in an obstetric unit in the United States显示文摘 | Fenner DE Genberg B Brahma P | 2003 | Am J Obstet Gynecol2003，189，： | 1 |
| 19 | Suppressor of cytokine signaling 1 regulates the immune response to infection by a unique inhibition of type I interferon activity 显示文摘 | Fenner JE Stair R Cornish AL | 2006 | Nat Imnauno12006，7，： | 1 |
| 20 | Mousepox (infectious ectromelia):past,present,and future显示文摘 | Fenner F | 1981 | Lab Anim Sci1981，31，5： | 1 |
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