关键词: 结核, 肺/预防和控制, 武汉市

Abstract: Objective  To investigate the patterns of health care seeking behavior and to identify the factors affecting the behavior among community TB suspects in Wuhan city, and to provide scientific basis for improvement of TB case detection.   Methods  We followed a cluster proportional random sampling method to select the 4 study communities (clusters), a total of 5878 people above 15 years old. A total of 270 people who had continuous cough, expectoration for more than two weeks, hemoptysis or who had bloody sputum within six months prior to the survey enrolled in the survey. All the participants received questionnaire interview and chest X-ray, sputum smear and culture examination. Two hundred and fifty-nine pieces of questionnaires were qualified with the 95.9% percent of pass. The chi-square test and logistic regression were used to analyze the factors affecting the health care seeking behavior among TB suspects.  Results  Among the 259 participants with eligible questionnaires, 79 cases (30.5%) did not seek any health care, 86 cases (33.2%) sought medical services from primary health care centers or general hospitals，89 cases（34.4%）had self-medication，while 5 cases（1.9%）had gone to private clinics. Multivariate logistic regression analysis showed that the availability of health insurance（β=1.225，Wald χ²=3.955, OR=3.405, 95%CI＝1.018-11.392, P<0.05）, the presence of severe or chronic respiratory symptom（β=1.601，Wald χ²=22.210，OR=4.959, 95% CI＝2.548-9.652, P<0.01）, and the feeling of stigmatization (β=0.927，Wald χ²=7.767，OR=2.528, 95%CI＝1.317-4.853，P<0.01) were correlated to the health seeking behavior to above community level health service center.  Conclusions  The proportion of TB suspects who actively sought health care was low. The health insurance, severe or chronic respiratory symptoms and stigmatization were the main factors affecting the health care seeking behavior among community TB suspects.

Key words: Tuberculosis,pulmonary/prevention &, control, Wuhan city