2023-09-28 14:46:10 +00:00
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abstract: 'Multi-drug resistant tuberculosis (MDR-TB) represents a threat to health
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and development in countries with high TB burden. China''s MDR-TB
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prevalence rate of 6.8\% is the highest in the world. Interventions to
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remove barriers against effective TB control, and prevention of MDR-TB
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are urgently needed in the country. This paper reports a cross-sectional
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questionnaire survey of 513 pulmonary TB (PTB) patients, and qualitative
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interviews of 10 healthcare workers (HCWs), and 15 PTB patients. The
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objective was to assess barriers against effective control of PTB and
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prevention of MDR-TB by elucidating the perspectives of patients and
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healthcare providers. Results showed that more than half of the patients
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experienced patient delay of over 12.5 days. A similar proportion also
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experienced detection delay of over 30 days, and delay in initiating
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treatment of over 31 days. Consulting a non-TB health facility >= 3
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times before seeking care at TB dispensary was a risk factor for both
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detection delay {[}AOR (95\% CI): 1.89(1.07, 3.34) and delay in
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initiating treatment{[}AOR (95\% CI): 1.88 (1.06, 3.36). Results
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revealed poor implementation of Directly Observed Therapy (DOT), whereby
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treatment of 34.3\% patients was never monitored by HCWs. Only 31.8\%
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patients had ever accessed TB health education before their TB
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diagnosis. Qualitative data consistently disclosed long patient delay,
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and indicated that patient''s poor TB knowledge and socioeconomic
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barriers were primary reasons for patient delay. Seeking care and being
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treated at a non-TB hospital was an important reason for detection
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delay. Patient''s long work hours and low income increased risk for
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treatment non-adherence. Evidence-based measures to improve TB health
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seeking behavior, reduce patient and detection delays, improve the
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quality of DOT, address financial and system barriers, and increase
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access to TB health promotion are urgently needed to address the
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burgeoning prevalence of MDR-TB in China.'
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affiliation: 'Li, Y (Corresponding Author), Third Mil Med Univ, Dept Social Med \&
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Hlth Serv Management, Chongqing, Peoples R China.
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Li, Ying; Liu, Ying, Third Mil Med Univ, Dept Social Med \& Hlth Serv Management,
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Chongqing, Peoples R China.
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Ehiri, John, Univ Arizona, Mel \& Enid Zuckerman Coll Publ Hlth, Div Hlth Promot
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Sci, Tucson, AZ USA.
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Oren, Eyal, Univ Arizona, Mel \& Enid Zuckerman Coll Publ Hlth, Div Epidemiol \&
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Biostat, Tucson, AZ USA.
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Hu, Daiyu; Wang, Qingya, Chongqing Inst TB Prevent \& Treatment, Chongqing, Peoples
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R China.
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Luo, Xingneng, Ctr Dis Control Shapingba Dist, Dept TB Control, Chongqing, Peoples
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R China.
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Li, Daikun, Chongqing Med Univ, Univ Town Hosp, Dept Lab Med, Chongqing, Peoples
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R China.'
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article-number: e88330
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author: Li, Ying and Ehiri, John and Oren, Eyal and Hu, Daiyu and Luo, Xingneng and
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Liu, Ying and Li, Daikun and Wang, Qingya
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author-email: lilyliying2012@163.com
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author_list:
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- family: Li
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given: Ying
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- family: Ehiri
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given: John
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- family: Oren
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given: Eyal
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- family: Hu
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given: Daiyu
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- family: Luo
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given: Xingneng
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- family: Liu
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given: Ying
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- family: Li
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given: Daikun
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- family: Wang
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given: Qingya
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da: '2023-09-28'
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doi: 10.1371/journal.pone.0088330
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files: []
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issn: 1932-6203
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journal: PLOS ONE
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keywords-plus: 'MULTIDRUG-RESISTANT TUBERCULOSIS; ANTITUBERCULOSIS-DRUG-RESISTANCE;
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RISK-FACTORS; PULMONARY TUBERCULOSIS; EPIDEMIOLOGY; PREVALENCE; DELAYS;
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TIME'
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language: English
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month: FEB 5
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number: '2'
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number-of-cited-references: '46'
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orcid-numbers: Oren, Eyal/0000-0001-7817-3516
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papis_id: 4b826a6b979a356127bb915a643da864
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ref: Li2014arewe
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researcherid-numbers: 'Oren, Eyal/AAD-5561-2019
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'
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times-cited: '17'
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title: Are We Doing Enough to Stem the Tide of Acquired MDR-TB in Countries with High
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TB Burden? Results of a Mixed Method Study in Chongqing, China
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000330829200177
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usage-count-last-180-days: '0'
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usage-count-since-2013: '26'
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volume: '9'
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web-of-science-categories: Multidisciplinary Sciences
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year: '2014'
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