2010
DOI: 10.1016/s0929-6646(10)60052-6
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Why is In-hospital Diagnosis of Pulmonary Tuberculosis Delayed in Southern Taiwan?

Abstract: To minimize IHDD, clinicians should carefully manage hospitalized patients with risk factors for prolonged delay, such as those with negative sputum smears, non-cavitary lesions on chest radiographs, admission to departments other than chest medicine/infectious diseases, exposure to fluoroquinolones before antitubercular treatment, underlying malignancy, and age > 65 years.

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Cited by 23 publications
(21 citation statements)
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“…Negative sputum smears are also correlated with delays for TB treatment in those diagnosed by LPA [30,31] because LPAs are generally performed on culture, rather than directly on specimen, in smear negative cases, resulting in significant delays in therapy (24 days vs 62 days) [32]. In addition to the diagnostic method used, the burden of TB in the setting may also contribute to delays in initiation.…”
Section: Discussionmentioning
confidence: 99%
“…Negative sputum smears are also correlated with delays for TB treatment in those diagnosed by LPA [30,31] because LPAs are generally performed on culture, rather than directly on specimen, in smear negative cases, resulting in significant delays in therapy (24 days vs 62 days) [32]. In addition to the diagnostic method used, the burden of TB in the setting may also contribute to delays in initiation.…”
Section: Discussionmentioning
confidence: 99%
“…Another study showed that weight loss is an independent predictor for pulmonary TB diagnosis [23]. Furthermore, the presence of radiographic changes, such as a miliary pattern, is associated with delayed initiation of treatment [23,24]. However, there is the possibility that weight loss and a military pattern on chest X-ray are more likely to occur in someone who has had untreated TB for a long period, and these findings may in fact be a result of a delay in treatment.…”
Section: Discussionmentioning
confidence: 99%
“…The incidence of tuberculosis infection was frequent in Japan prior to the 1960s, and the aging of these infected individuals is one of the reasons for the relatively high prevalence in Japan at present (7)(8)(9)11). Elderly patients tend not to present with typical symptoms, such as weight loss, coughing and fever, and may not be able to expectorate sputum spontaneously, resulting in a delayed diagnosis (6,7,9,12,13). In addition, as the life expectancy of the Japanese population increases, the increasing incidence of aspiration pneumonia in elderly patients emerges as a key medical and healthcare concern (1,2,4,5,14,15).…”
Section: Discussionmentioning
confidence: 99%
“…The diagnostic delay of tuberculosis can be divided into patient and doctor delay (12,16,17). Patient delay refers to the time from the onset of symptoms to the first visit to a medical institution, and doctor delay refers to the time from the patient's first visit to the doctor to diagnosis.…”
Section: Discussionmentioning
confidence: 99%