Determinants of health system delay among confirmed tuberculosis cases in Spain

Díez, Mercedes; Bleda, M.J.; Alcaide, J.; Castells, C; Cardenal, Juan; Domínguez, A.; Gayoso, P; Guitiérrez, G.; Huerta, Consuelo; López, María José; Moreno, Tamara; Muñoz, Flor M.; Garcı́a-Fulgueı́ras, Ana; Picó, María Dolores; Pozo, Francisco; Quirós, J.; Robles, Fernández; Martínez‐Sánchez, Jose M.; Vanaclocha, Hermelinda; Vega, T. González-Carrascosa

doi:10.1093/eurpub/cki010

Cited by 31 publications

(25 citation statements)

References 12 publications

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“…Even though the relationship between TB and silicosis is well documented, a study in Spain found that presence of silicosis was an independent risk factor for health system delay in diagnosing and treating patients with TB [103]. This may be due to the fact that the diagnosis of TB among silicotics can be very difficult, especially in lower grades, when the clinical manifestations can be benign and the radiological alterations can be indistinguishable from those resulting from the preexisting silicosis [104].…”

Section: Silicosismentioning

confidence: 99%

Tuberculosis and noncommunicable diseases: neglected links and missed opportunities

Creswell¹,

Raviglione²,

Ottmani³

et al. 2010

European Respiratory Journal

125

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Globally, the incidence of tuberculosis (TB) is declining very slowly, and the noncommunicable disease (NCD) burden for many countries is steadily increasing. Several NCDs, such as diabetes mellitus, alcohol use disorders and smoking-related conditions, are responsible for a significant proportion of TB cases globally, and in the European region, represent a larger attributable fraction for TB disease than HIV. Concrete steps are needed to address NCDs and their risk factors. We reviewed published studies involving TB and NCDs, and present a review and discussion of how they are linked, the implications for case detection and management, and how prevention efforts may be strengthened by integration of services. These NCDs put patients at increased risk for developing TB and at risk for poor treatment outcomes. However, they also present an opportunity to provide better care through increased casedetection activities, improved clinical management and better access to care for both TB and NCDs. Hastening the global decline in TB incidence may be assisted by strengthening these types of activities.

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Section: Silicosismentioning

confidence: 99%

Tuberculosis and noncommunicable diseases: neglected links and missed opportunities

Creswell¹,

Raviglione²,

Ottmani³

et al. 2010

European Respiratory Journal

125

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“…In a study conducted in Spain it was found that a factor related to a longer delay in the TB diagnosis was the fact that the symptomatic patient sought primary healthcare units which were not prepared for the performance of the diagnosis of the disease. In the same study, the fact that the patient with TB symptoms sought the hospital for care represented a decrease in the time between the onset of the symptoms and the diagnosis of the disease (5) .…”

mentioning

confidence: 91%

“…The increase in the delay in the performance of the diagnostic test and initiation of the treatment leads to an increased risk of disease transmission, especially in urban environments, and this condition of the healthcare services reduces the chance of a cure for the TB patient. Factors related to the patient and the health services can contribute to this delay in the performance of the TB diagnosis and many of these are interlinked to the organization of the health services, whether public or private (4)(5) . Studies carried out in different places such as Shanghai, Spain, Hong Kong and Brazil have shown that some of these factors are related to the kind of health service sought by the TB patient, the type of service that performs the diagnosis and the diagnostic tools employed by the healthcare service (4,6) .…”

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confidence: 99%

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A porta de entrada para o diagnóstico da tuberculose no sistema de saúde de Ribeirão Preto/SP

Oliveira

Arcêncio

Ruffino-Netto

et al. 2011

Rev. esc. enferm. USP

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O primeiro contato do doente de tuberculose (TB) com o sistema de saúde se dá na porta de entrada, e é fundamental para o acesso ao diagnóstico. Objetivou-se identificar e analisar a porta de entrada no sistema de saúde de Ribeirão Preto para o diagnóstico da TB. Baseou-se em um instrumento do Primary Care Assessment Tool, adaptado para a TB no Brasil. Realizou-se entrevista estruturada com 100 doentes de TB diagnosticados entre Junho de 2006 e Julho de 2007. Destes, 61% chegaram ao local de diagnóstico por encaminhamento e apenas 29% se apresentaram espontaneamente; 66% procuraram por serviços de atenção primária, 34% por serviços de nível secundário e terciário. Ademais, 89% foram diagnosticados em serviços públicos e destes, 44% foram diagnosticados nos pronto-atendimentos. Além disso, 88% foram diagnosticados fora de sua área de abrangência. Apesar dos doentes terem procurado atendimento na atenção primária e mais próximo de suas residências, o diagnóstico se deu na atenção secundária e terciária.

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“…It is a considerable problem in tuberculosis (TB), as it increases the infectious pool in the community (increases the time a patient stays infected) and also the mortality rate (1). This includes patient delay (PD) (from the onset of symptoms to the first contact with the health services) and health system delay (HSD) (from the first visit to the health services to the initiation of correct treatment) (2, 3). …”

mentioning

confidence: 99%

Two vicious circles contributing to a diagnostic delay for tuberculosis patients in Arkhangelsk

Кузнецов

Grjibovski

Mariandyshev

et al. 2014

Emerging Health Threats Journal

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SettingDelay in tuberculosis (TB) diagnosis increases the infectious pool in the community and the risk of development of resistance of mycobacteria, which results in an increased number of deaths.ObjectiveTo describe patients’ and doctors’ perceptions of diagnostic delay in TB patients in the Arkhangelsk region and to develop a substantive model to better understand the mechanisms of how these delays are linked to each other.DesignA grounded theory approach was used to study the phenomenon of diagnostic delay. Patients with TB diagnostic delay and doctors–phthisiatricians were interviewed.ResultsA model named ‘sickness trajectory in health-seeking behaviour among tuberculosis patients’ was developed and included two core categories describing two vicious circles of diagnostic delay in patients with TB: ‘limited awareness of the importance to contact the health system’ and ‘limited resources of the health system’ and the categories: ‘factors influencing health-seeking behaviour’ and ‘factors influencing the health system effectiveness’. Men were more likely to report patient delay, while women were more likely to report health system delay.ConclusionsTo involve people in early medical examinations, it is necessary to increase alertness on TB among patients and to improve health systems in the districts.

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Determinants of health system delay among confirmed tuberculosis cases in Spain

Abstract: Despite free health care being universally available in Spain, there are some groups of TB patients whose treatment is unduly delayed.

Cited by 31 publications

References 12 publications

Tuberculosis and noncommunicable diseases: neglected links and missed opportunities

Tuberculosis and noncommunicable diseases: neglected links and missed opportunities

A porta de entrada para o diagnóstico da tuberculose no sistema de saúde de Ribeirão Preto/SP

Two vicious circles contributing to a diagnostic delay for tuberculosis patients in Arkhangelsk

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