Delay in the treatment of pulmonary tuberculosis: a report from Afghanistan

Sabawoon, Wrishmeen; Sato, Hajime; Kobayashi, Yasuki

doi:10.1007/s12199-011-0219-9

Cited by 31 publications

(39 citation statements)

References 9 publications

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“…Similarly, majority of TB patients involved in this study were from the rural parts of south Ethiopia. In line with the findings of the present study, inquiries made by researchers in Afghanistan [8], Nigeria [13] and Indonesia [16] had found being resident in the rural area as risk factor for delayed initiation of treatment. The main reasons for this unacceptably longer duration before treatment might be due to geographical access to health service and cost of transportation to reach to the health facility in a longer distance from their residence [12].…”

Section: Discussionsupporting

confidence: 91%

“…The median delay was lower than the estimate in India [9], Afghanistan [8], Kathmandu in Nepal [14], Brazil [10], Indonesia [16] and West Midland in England [17]. This difference emanates from only new smear positive pulmonary TB patients in Nepal, Brazil and Afghanistan partly.…”

Section: Discussionmentioning

confidence: 68%

“…Two previous studies conducted in Ethiopia indicate that the median total delay was 70.5 days in Afar regional state and 97 days in Bale Zone in Oromia regional state [6,7]. The highest delay (357 days) observed as to the knowledge of the authors were considered was in Afghanistan [8]. These and other related studies conducted in different geographical locations in the glob have assessed factors favoring delayed diagnosis and treatment of TB.…”

Section: Introductionmentioning

confidence: 84%

“…Increased distance requires additional cost for transportation which hinders the patient to visit health facility as early as possible [6][7][8][9][10][11][12][13]. As it is known as the most important risk factor for TB, smoking cigarette also increases the delay for diagnosis and treatment as compared to non-smokers and ex-smokers [14].…”

Section: Introductionmentioning

confidence: 99%

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Treatment Delay among Smear Positive Pulmonary Tuberculosis Patients in South Ethiopia: A Cross-Sectional Study

Zeleke¹

2014

SJPH

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Abstract:Background: Most tuberculosis (TB) patients were not visiting heath facility but transmit disease to healthy individuals in the community for longer time in Ethiopia. This study was aimed at estimating duration of delay for initiation of anti-TB treatment by smear positive pulmonary TB in south Ethiopia and assesses its determinants of patient related factors associated with unacceptable delay for medication of TB. Methods: a cross-sectional study design was used to recruit 218 consecutive smear positive pulmonary TB patients visiting there hospitals in Gamo Goffa Zone. A structured questionnaire was used to collect information on socio demographic, economic, behavioral factors and co morbidity with HIV from the study units. The median delay was used as cut-off point to dichotomize acceptable delay from unacceptable one. Pearson chi square and logistic regressions were used to assess association between patient factors and longer delay before treatment. Results: The median delay for initiation of anti-TB medication by smear positive pulmonary TB patients was 35 days. Fifteen of the study participants were HIV positive and equal number of TB patients involved had previous history of TB. Socio-demographic factors significantly associated with longer delay for treatment of TB in Univariate analysis were place of residence, level of education and marital status while economic factors associated were monthly income, whether the house is owned or rented and ceiling status of the house. However, after controlling the effect of confounding variables only place of residence and monthly income remained statistically significant. TB patients from rural area were 2.82 times at increased risk to delay for longer days than those living in the town (p-value= 0.021). Similarly, patients having monthly income of 450 or less Ethiopian birr were 4.96 times more likely to delay for longer time than those who had no regular monthly income (p-value=0.003). Conclusion: Smear positive pulmonary TB patients delay for more days before taking anti-TB medications which renders them noninfectious after a few weeks of treatment began. They were transmitting the disease in the community making prevention and control more difficult. Those living in the rural area and earn least amount of money per month transmit the disease for longer time. Civil servants who earn the least salary per month had significant increment in the salary recently that might prevent their delay. However, access to diagnosis and treatment of TB for people living in the rural area should be improved so as to help the walk towards the millennium development goal targets.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

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Treatment Delay among Smear Positive Pulmonary Tuberculosis Patients in South Ethiopia: A Cross-Sectional Study

Zeleke¹

2014

SJPH

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“…The diagnostic delays observed in the studied patients are lower than those reported from EMR and countries of origin of the patients [7][8][9][10][11][12][13]. A systematic review of the Indian literature found that the patient, diagnostic and treatment delay were 18.4, 31.0 and 2.5 days, respectively, and the median total delay of 55.3 days [14].…”

Section: Discussionmentioning

confidence: 63%

Diagnosis Delay among Newly Tuberculosis Patients Admitted in a Community Hospital

Garcell¹,

Zenón²,

Arias³

et al. 2017

J Epid Prev Med

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Objective: To determine the diagnostic delay in newly diagnosed tuberculosis (TB) patients admitted to a community hospital in Qatar. Design:The study was conducted from January 2013 today 2016. The following information was collected from patient file: Age, sex, nationality, tuberculosis type, time of symptoms onset, time of the confirmatory test, and the time of visiting an HCP before the admission encounter.Results: Of the 390 TB patients included in the study, 281 (72.1%) were from South East Asian countries, 325 (83.3%) patients were males and 65 (16.7%) were females, mean age was 32.4 years. Of the 390 patients, 89.7% (350 patients) had pulmonary tuberculosis and 40(10.3%) patients had non-pulmonary localization. The median total delay was 30 days (15;60 days), while the patient delay was 10 days (4;27 days) and the system delay was 3 days (3;7.8 days). For pulmonary tuberculosis, the total delay was 30 days and for non-pulmonary localization was 15 days. Conclusion:The study provides an insight about the delay in the diagnosis of TB at a community hospital in Qatar. Additional studies should be conducted to evaluate the delay in a representative national sample and to identify the factors associated with patients' delays, which could be used to strengthen the national program for tuberculosis control.

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Total, Patient and System Diagnostic Delays for Pulmonary Bacilliferous Tuberculosis in the Six Diagnostic and Treatment Centers in the Five Health Districts of the Central Region, Burkina Faso, 2018

Yanogo

Balima²,

Méda

2022

J Epidemiol Glob Health

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Introduction Long diagnosis delay contributes significantly to the failure to eradicate tuberculosis. The objective of this study was to evaluate the total, patient and system delays in diagnosis of pulmonary bacilliferous in the six tuberculosis Diagnostic and Treatment Centers in the five health districts of the central region in Burkina Faso. Methods A descriptive cross-sectional study was conducted among 384 microscopy-positive pulmonary tuberculosis patients in 2018 to address this objective. It concerned the socio-demographic, clinical, microbiological characteristics, and referral location/pathway characteristics of the patients. We then calculated the different delays. The “patient” (time from first symptoms to first consultation), “system” (time from first consultation to first diagnosis) and total (time from first symptoms to diagnosis) median diagnostic delay were estimated. Results The median “total”, “patient” and “system” diagnostic times were 37, 21 and 7 days, respectively. Of the 384 patients surveyed, 158 patients or 41.25% of patients had a long total diagnostic delay (> 45 days). The number of patients with a long system diagnostic delay was 125 patients (32.55%; p < 0.001) and those with a long patient diagnostic delay were 105 patients (27.34%; p < 0.001). Conclusion The total diagnosis delay of pulmonary tuberculosis was long for almost half of the patients. Awareness of the signs of tuberculosis among patients and caregivers, and consultation in a health center must be intensified to help considerably reduce these delays.

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Delay in the treatment of pulmonary tuberculosis: a report from Afghanistan

Cited by 31 publications

References 9 publications

Treatment Delay among Smear Positive Pulmonary Tuberculosis Patients in South Ethiopia: A Cross-Sectional Study

Treatment Delay among Smear Positive Pulmonary Tuberculosis Patients in South Ethiopia: A Cross-Sectional Study

Diagnosis Delay among Newly Tuberculosis Patients Admitted in a Community Hospital

Total, Patient and System Diagnostic Delays for Pulmonary Bacilliferous Tuberculosis in the Six Diagnostic and Treatment Centers in the Five Health Districts of the Central Region, Burkina Faso, 2018

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