RISK FACTORS FOR THE LATE DIAGNOSIS OF DERMATOVENEROLOGICAL DISEASES

Abstract

Relevance. Dermatovenerological diseases are characterized by high prevalence, clinical polymorphism and considerable medical and social significance. Despite the development of diagnostic technologies, a high frequency of late diagnosis persists in clinical practice, leading to chronicity of the pathological process, the development of complications and a decline in the quality of life of patients. In this connection, the study of the risk factors for the late detection of dermatovenerological diseases remains a relevant scientific and practical task. Aim. To identify and analyse the main risk factors for the late diagnosis of dermatovenerological diseases in patients of various ages and social status. Materials and methods. A retrospective-prospective observational study was carried out involving 120 patients with dermatovenerological diseases aged from 18 to 65 years. The criterion of late diagnosis was the establishment of a clinical diagnosis more than 6 months after the appearance of the first symptoms. Clinical and anamnestic analysis, assessment of socio-demographic indicators, analysis of medical records and methods of statistical data processing with the use of descriptive statistics and the χ² criterion were applied. Differences were considered statistically significant at p < 0.05. Results. Late diagnosis was identified in 46.7 % of patients. It was established that a significantly higher frequency of late detection was associated with a low level of education, residence in rural areas, a tendency towards self-medication and an underestimation of clinical symptoms. A substantial role was played by psychological factors, including the stigmatization of skin and venereal diseases and fear of seeking specialized care, as well as by organizational problems of the health-care system — the limited availability of specialized care and insufficient alertness of primary-care physicians. Late diagnosis was recorded more often in atypical and oligosymptomatic courses of disease. Conclusion. The late diagnosis of dermatovenerological diseases is multifactorial in nature and is caused by a combination of socio-demographic, behavioural, psychological, clinical and organizational factors. The data obtained substantiate the need for a comprehensive approach aimed at raising the health literacy of the population, optimizing the routing of patients and improving the system of early diagnosis.