SUMMARY – Currently, topical are studies that examine different reasons for delay of tuberculosis (TB) diagnosis and its impact on disease prognosis. The aim was to examine three time periods associated with treatment delay: patient related, health system related and total delay. This retrospective-prospective study included 100 consecutive patients hospitalized at Department of Pulmonology, Clinical Center of Serbia, in the period from March to December 2015. Study results showed median patient delay to be 92.5 days. Total delay was affected by patient related delay. Median healthcare delay was 18.5 days. Patients that reported excessive alcohol consumption were more likely to have prolonged time to seek medical help. Years of alcohol consumption yielded moderate positive correlation with patient related delay (r=0.362, p<0.001). Correlation between the number of cigarettes and patient delay was moderate, positive and statistically significant (r=0.314, p=0.001). Delay in seeking medical help was more likely in patients with negative family history of TB. There was no difference in the effect of the presence of symptoms on patient related delay (p>0.05). Clinical characteristics such as patient TB category and chest radiograph abnormalities were not associated with prolonged patient related delay (p>0.05). Study results point to the importance of health education and/or health intervention in the population group at a high risk of TB.
Sažetak Uvod. Pušenje i tuberkuloza spadaju među najznačajnije probleme u oblasti javnog zdravlja, od čega je pušenje odgovorno za 5 miliona smrtnih ishoda godišnje, a tuberkuloza za gotovo 2 miliona letalnih ishoda, od čega je pušenje odgovorno za pola miliona smrtnih ishoda kod obolelih od tuberkuloze. Diskusija i pregled literature. Nikotin je značajan supresor funkcije makrofaga, dendritskih ćelija i T-limfocita, što objašnjava imunosupresivna svojstva pušenja koja pomažu razvoju infekcije. Duvanski dim sadrži brojne supstancije sa imunomodulatornim efektom, uključujući nikotin, ugljen-monoksid, akrolein, peroksinitrite i mnoge druge. Dominantan imunološki i patofiziloški mehanizam je smanjenje sinteze faktora nekroze tumora u makrofagima pluća što dovodi do povećane osetljivosti osoba koje su izložene duvanskom dimu za razvoj aktivne tuberkuloze nakon infekcije, kao i povećane osetljivosti za razvoj drugih infekcija, kao što su infekcije Gram-negativnim bakterijama. Na osnovu epidemioloških studija i proučavanja ovog problema u poslednjih 50 godina, Svetska zdravstvena organizacija je objavila da pušenje povećava rizik za nastanak infekcije koju uzrokuje M. Tuberculosis, povećava rizik za progresiju infekcije u aktivno oboljenje i rizik za smrtni ishod. Prevalencija tuberkuloze je veća kod pušača i bivših pušača, nego kod nepušača. Rizik od pojave tuberkuloze je dozno-zavisan od broja popušenih cigareta i dužine pušačkog staža. Kod dece koja žive sa osobama obolelim od aktivne tuberkuloze, pasivno pušenje ubrzava razvoj aktivne tuberkuloze. Zaključak. Imajući u vidu višestruke posledice udruženosti tuberkuloze i pušenja, prevencija pušenja mogla bi da predstavlja značajnu meru u kontroli tuberkuloze.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.