性别与社区潜在结核病患者就医行为的关系  

Gender Differences in Health Seeking Behaviour and Tuberculosis Care Access of Potential TB Patients

作　　者：刘冬梅[1] 费杨[2] 任群慧[1] 汪玉纯[1] 刘仁国[1] 徐飚[2] 

机构地区：[1]当阳市疾病预防控制中心,湖北当阳444105 [2]复旦大学公共卫生学院流行病学教研室,上海200032

出　　处：《中国初级卫生保健》2006年第10期58-60,共3页Chinese Primary Health Care

基　　金：UNICEF/UNDP/World Bank/WHOS pecialProgramme for Research and Trainingin Tropical Disease(TDR)基金的资助(基金号:WHO/TDR/SEBA30244)

摘　　要：目的探讨咳嗽满3周的潜在结核病患者就医行为和获得结核病诊疗服务可及性方面的性别差异。方法以结核病控制项目地区的湖北省当阳市为现场,通过随机整群抽样,对从18个村27458名14岁以上常住居民中识别的262例持续咳嗽或咳痰满3周的潜在结核病患者进行问卷调查和胸透及痰涂片检查,胸透异常者给予X线摄片检查。结果调查共发现262例(9.5‰)咳嗽满3周的潜在结核病患者,其中男性174例(12.5‰),女性88例(6.5‰)。虽然女性就诊率(59.1%)高于男性就诊率(37.9%)(P=0.001),但于男性相比女性更倾向于选择药房、村卫生室等质量较低的医疗机构。118例有就诊经历的患者中4例接受了痰涂片检查,均为男性。结论社区女性潜在结核病患者比男性更倾向寻求医疗服务,但医疗服务质量不如男性。男女患者获得结核病诊疗服务可及性均不高。OBJECTIVE To explore gender differences in health seeking behaviour and tuberculosis care access of individuals with a cough lasting for more than three weeks （potential TB cases） . METHODS Randomized cluster sampling was used to select 18 villages as the study sites from 57 villages in a county with national TB control program -Dangyang in Hubei Province, China. 262 patients with chronic cough, identified from all residents （n=27458） aged〉14 years wereinterviewed using a structured questionnaire. Fluoroscopy, chest X-ray and sputum smear wereused for diagnosis. RESULTS A total of 262 people （9.5 per thousand） , including 174 men （ 12.5 perthousand） and 88 women （6.5 per thousand） , reported a prolonged cough during three monthsprior to the interview. Although women were more likely to seek health care than men （59.1%vs.37.9%, P=0.001 ）, more women chose the less-qualified health care providers （village heahhstations or drug-sellers） . Among 118 cases who took health care actions, 4 cases reported havinghad a sputum smear test, all of whom were men. CONCLUSION Potential TB cases of women aremore likely to seek health care than men in the study population, but to choose less-qualifiedheahh care providers. Both men and women have poor access to tuberculosis care.

关 键 词：肺结核 性别 慢性咳嗽 就医行为 

分 类 号：R183[医药卫生—流行病学]