Delay in the diagnosis, notification and initiation of treatment and compliance in children with tuberculosis

Beyers, Nulda; Gie, Robert P.; Schaaf, H. Simon; Zyl, S. van; Nel, E. D.; Talent, Jim; Pr, Donald

doi:10.1016/0962-8479(94)90130-9

Cited by 48 publications

(35 citation statements)

References 7 publications

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“…The mean total delay (88 days) was also lower than Ghana and Australia that showed about 240 and 104 days respectively [11-13]. These differences could be due to the selection of the study population.…”

Section: Discussionmentioning

confidence: 99%

Patient and health service delay in the diagnosis of pulmonary tuberculosis in Ethiopia

2002

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Background: Delay in the diagnosis of tuberculosis may worsen the disease, increase the risk of death and enhance tuberculosis transmission in the community. This study aims to determine the length of delay between the onset of symptoms and patients first visit to health care (patient delay), and the length of delay between health care visit and the diagnosis of tuberculosis (health service delay).

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Section: Discussionmentioning

confidence: 99%

Patient and health service delay in the diagnosis of pulmonary tuberculosis in Ethiopia

2002

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“…The mortality and morbidity from childhood TB may be influenced by the delay from the time of first symptoms until the start of compliant treatment, 9 and this delay may further be prolonged before appropriate treatment is started in the case of MDR TB. The delay from diagnosis of TB to appropriate treatment can be short and similar to that of drug susceptible cases if a history of contact with an infectious case of MDR TB is obtained from the outset (table 2).…”

Section: Discussionmentioning

confidence: 99%

“…Delay in diagnosis and treatment of tuberculosis can be due to patient delay or doctor delay; for example, late presentation with symptoms or failure of the doctor to consider the diagnosis of tuberculosis. 9 In the case of drug resistant tuberculosis this delay in initiating effective treatment can be even longer, especially if the attending physician does not consider the diagnosis, but also because of the time required for culture of the organism and determination of drug susceptibility (that is, laboratory delay).…”

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confidence: 99%

Culture confirmed multidrug resistant tuberculosis: diagnostic delay, clinical features, and outcome

Schaaf

Shean²,

Donald³

2003

Archives of Disease in Childhood

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Aims: To determine the delay in diagnosis of multidrug resistant (MDR) tuberculosis (TB), the correlation between drug susceptibility patterns of adult-child contact pairs, the effectiveness of treatment, and the outcome in these children. Methods: MDR M tuberculosis culture results of children were prospectively collected during a four year period in the Western Cape Province of South Africa, an area with a TB incidence of 589/100 000 population, and a new MDR TB rate of 0.94%. Folder reviews were done to retrieve clinical information. Children not already on treatment at our MDR TB clinic or TB hospital were recalled and appropriate treatment was started. Follow up was done for as long as possible. Results: Thirty nine children, median age 4.5 years at first TB diagnosis and 6.2 years on MDR culture confirmation, were seen. Delay in starting appropriate MDR treatment after TB diagnosis was a median of 2 days if MDR TB source cases were taken into account, but 246 days if the drug susceptibility pattern of the source case was not considered, and 283 days if there was no known tuberculosis source case. Correlation between the drug susceptibility results of the child's and adult source case's isolates was 68%. Seventeen children had smear positive tuberculosis, of whom 13 had cavitatory pulmonary disease. Eight children had central nervous system TB. Thirty six children were treated for MDR tuberculosis, of whom four died. Conclusions: Obtaining a detailed contact history is essential as a delay in starting appropriate MDR antituberculosis treatment has potentially serious consequences.

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“…It is now becoming increasingly apparent that some children simply do not take the drugs they are prescribed. Based on experience with asthma,3 tuberculosis,4 cystic fibrosis,5 diabetes,6 and penicillin prophylaxis for sickle cell disease,7 we know that children often fail to follow important diets or treatment schedules. It is therefore illogical to assume that, just because they have a life threatening disease, young patients with leukaemia will all reliably take pills every day without fail for two years when they (mostly) are in normal health.…”

Section: An Overlooked and Costly Cause Of Late Relapsementioning

confidence: 99%

Non-compliance with oral chemotherapy in childhood leukaemia

Lilleyman

Lennard

1996

BMJ

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as infections, infestations, or other factors related to bird keeping in different countries.Another potential explanation for the discrepancy is that neither of the two new studies has looked specifically at pigeon keeping, which was the only significant association with lung cancer in the study from Scotland.5 In Britain at least there is likely to be a substantial difference in the number ofbirds kept, and consequent degree of exposure, between those keeping pigeons for racing and those who keep one or two birds as indoor domestic pets. It is perhaps still possible that the previously reported associations relate to an underlying effect that is specific to pigeon keeping.To resolve these uncertainties it would be necessary to repeat these studies yet again in the populations that gave rise to the original observations of an association, taking particular care to deal with confounding effects. However, these two new studies seem to be conclusive in two respects. First, they 6 Britton JR, Lewis S. Pet birds and lung cancer [editorial].

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Delay in the diagnosis, notification and initiation of treatment and compliance in children with tuberculosis

Cited by 48 publications

References 7 publications

Patient and health service delay in the diagnosis of pulmonary tuberculosis in Ethiopia

Patient and health service delay in the diagnosis of pulmonary tuberculosis in Ethiopia

Culture confirmed multidrug resistant tuberculosis: diagnostic delay, clinical features, and outcome

Non-compliance with oral chemotherapy in childhood leukaemia

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