Delay in the diagnosis and management of tuberculosis among patients in the Suez Canal Area

The Egyptian Journal of Bronchology

Eman R. Hamed¹  Lamiaa A. Fiala²  Amany H. Refaat²  Noha M. Abu Bakr Elsaid² 

[1] Department of Internal Medicine, Chest Diseases and Tuberculosis, Faculty of Medicine, Suez Canal University;Department of Public Health, Community, Environmental and Occupational Medicine, Faculty of Medicine, Suez-Canal University;

关键词: health-care system delay;    patient delay;    Suez Canal Area and Egypt;    total delay;    tuberculosis;   

DOI  :  10.4103/ejb.ejb_8_19

来源: DOAJ

【 摘 要 】

Abstract Background Delayed diagnosis of tuberculosis (TB) can enhance the transmission of infection and worsen prognosis. Aim To identify the risk factors of delay in the management of TB cases for early management. Patients and methods A cross-sectional analytic study was performed to assess the proportion, duration of delay, and its determinants in the diagnosis and management of TB. To assess the risk factors of delay, the sample was dichotomized into ‘delay’ and ‘nondelay’ groups taking the median total delay in the diagnosis and management of TB as a cutoff point. The study included 183 TB patients, who were registered in TB records during the study period (first of January to end of June, 2017). Data were collected by an interview questionnaire. Results Nearly half of patients (49.20%) had unacceptable total delay in the diagnosis and management of TB. The median of total delay, patient delay, and health-care system delay were 65, 14, and 20 days, respectively. Significant risk factors of total delay in the diagnosis and management of TB were not consulting the health-care provider after onset of symptoms (P=0.002), visiting initially the health facility other than the chest hospital/TB clinics (P=0.019), not consulting a chest physician initially (P=0.043), negative sputum smear (P=0.001), more than two health visits before initial diagnosis (P<0.001), while low-degree TB stigma was protective (P=0.006). Conclusion Nearly half of patients had unacceptable total delay in the diagnosis and management of TB. The main determinants were seeking pharmacies instead of visiting health-care providers, not visiting initially chest hospital/TB clinics, not consulting a chest physician initially, negative sputum smear, and more than two health visits before initial diagnosis.

【 授权许可】

Unknown