Characteristics of patients with delayed diagnosis of infectious pulmonary tuberculosis

Introduction:Delay in the diagnosis of tuberculosis (TB) can lead to an increased infectivity period, delayed treatment, and increased severity of the disease. The objective of this study was to estimate the diagnostic delay and factors associated with the delay in diagnosis among the newly diagnosed smear-positive pulmonary TB patients in Kerala, India.Materials and Methods:A cross-sectional study was conducted among TB patients who were in the intensive phase of directly observed treatment short-course treatment in four randomly selected TB units in a district in Kerala during the years 2012–2013. Diagnostic delay was defined as the delay between the onset of symptoms and diagnosis. Data collection using a modified World Health Organization questionnaire was done by interviewing 302 participants.Results:Mean age of the participants was 48.6 ± 14.5 years. Males constituted 76.5% of the study population. The mean diagnostic delay was 43.5 ± 29.1 days (median: 37 days). The median patient and health system delays were 16 days and 15 days, respectively. Patient delay (55.6%) contributed more than health system delay (44.4%). Poor knowledge about TB, first consulting a private physician, and increased number of consultations were found to be significantly associated with diagnostic delay.Conclusion:The diagnostic delay in tuberculosis reported in this study was lower than other studies in India but it needs further reduction. Both patients and health providers play a role in a delay in diagnosis, and poor knowledge about the disease among the patients was one of the main risk factors. Interventions to improve knowledge and awareness of the disease and to increase the suspicion of chest symptomatic by health-care providers in the private sector are vital to reduce diagnostic delay.

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“…However, a study by Phoa et al . [ 12 ] in Singapore showed a median diagnostic delay of 4 weeks which was lower than our findings.…”

Section: Discussioncontrasting

confidence: 90%

Diagnostic delay and associated factors among patients with pulmonary tuberculosis in Kerala

Paramasivam

Bina

Chandran

et al. 2017

J Family Med Prim Care

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“…Delayed initial health care-seeking was defined as any duration of delay in excess of the median as ascertained in the study [6]. The self-reported symptoms included major symptoms of PTB, such as cough, expectoration, hemoptysis and bloody sputum, and common symptoms for PTB, such as chest distress, chest pain, mild fever, night sweat, weakness, poor appetite and weight loss [13].…”

Section: Methodsmentioning

confidence: 99%

“…The expected prevalence of delayed initial health care-seeking is 50% using the median as cut-off point [6]. With both type I error rate = 5% and relative error rate = 10–15%, using sample size estimation methods of cross-sectional study, the estimated range of sample size required was approximately 200 to 400 patients.…”

Section: Methodsmentioning

confidence: 99%

“…Similar observations about delayed diagnosis or delayed treatment have also been made in other countries. For instance, the median interval to diagnosis of infectious TB was 4 weeks in Singapore [6]. In Indonesia, the median total delay for PTB patients in urban districts was 8 weeks compared to 12 weeks for patients in rural districts [7].…”

Section: Introductionmentioning

confidence: 99%

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Predictors on Delay of Initial Health-Seeking in New Pulmonary Tuberculosis Cases among Migrants Population in East China

Jiang

et al. 2012

PLoS ONE

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ObjectivesTo determine the length of delay in initial health-seeking in new pulmonary tuberculosis (PTB) cases among migrant population in the eastern part of China, and factors associated with it.MethodsA cross-sectional study was conducted using a structured questionnaire in six counties in Shanghai, Guangdong and Jiangsu from May to October, 2008, to estimate the extent and factors responsible for delayed initial health-seeking of the new PTB cases. The interval between self-reported onset of TB symptoms and date of first attendance at any medical institution was determined. More than the median duration was defined as delayed health-seeking.ResultsA total of 323 new migrant PTB patients participated in the study. Only 6.5% had medical insurance. The median and mean durations to initial health-seeking were respectively 10 and 31 days. There was no significant association between socio-demographic factors and delayed initial health-seeking. Average monthly working days >24 (AOR, 1.61; 95% CI, 1.03–2.51), and hemoptysis or bloody sputum (AOR, 0.48; 95% CI, 0.28–0.85) were significantly associated with delayed initial health-seeking.ConclusionsInterventions to improve health seeking behavior among the migrant population in China must focus on strengthening their labor, medical security and health education.

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Identifying the most infectious lesions in pulmonary tuberculosis by high-resolution multi-detector computed tomography

et al. 2010

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Characteristics of patients with delayed diagnosis of infectious pulmonary tuberculosis

Abstract: Further studies are needed to identify the possible reasons for delayed diagnosis of TB among those < 65 years old, in the Chinese population in Singapore.

Cited by 15 publications

References 5 publications

Diagnostic delay and associated factors among patients with pulmonary tuberculosis in Kerala

Diagnostic delay and associated factors among patients with pulmonary tuberculosis in Kerala

Predictors on Delay of Initial Health-Seeking in New Pulmonary Tuberculosis Cases among Migrants Population in East China

Identifying the most infectious lesions in pulmonary tuberculosis by high-resolution multi-detector computed tomography

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