Patterns of delays in diagnosis amongst patients with smear-positive pulmonary tuberculosis at a teaching hospital in Turkey

Abstract

In total, 151 newly diagnosed patients with smear-positive pulmonary tuberculosis were studied. The mean time from the onset of symptoms to the first visit to a physician was 46.4 days; the mean referral delay was 28.9 days; the mean delay in diagnosis was 2.4 days; and the mean delay in treatment initiation was 0.8 days. There was a delay in consulting a physician by 49% of patients. A low index of suspicion for tuberculosis on the part of the physician and healthcare system and laboratory delays were the most common reasons for delays in diagnosis.

Delays in the Diagnosis and Treatment of Pulmonary Tuberculosis

“…Although the authors have described different duration intervals for the criteria of delays, the following operational criteria for delays have been usually used in most studies. Patient delay: The patient's application intervals that exceeded 30 days were considered indicative of a patient delay in smear-negative and smear-positive patients (10,12,(20)(21)(22). Health care system delay or doctor delay: While health care system intervals that exceeded four days were considered indicative of a doctor delay in smear-positive patients (10,20,22), a period of more than 15 days was indicative of a doctor delay in smear-negative patients (12,22).…”

“…Patient delay: The patient's application intervals that exceeded 30 days were considered indicative of a patient delay in smear-negative and smear-positive patients (10,12,(20)(21)(22). Health care system delay or doctor delay: While health care system intervals that exceeded four days were considered indicative of a doctor delay in smear-positive patients (10,20,22), a period of more than 15 days was indicative of a doctor delay in smear-negative patients (12,22). Referral delay: The referral intervals that exceeded two days were considered indicative of a referral delay in smear-negative and smear-positive patients (10,(20)(21)(22).…”

“…Health care system delay or doctor delay: While health care system intervals that exceeded four days were considered indicative of a doctor delay in smear-positive patients (10,20,22), a period of more than 15 days was indicative of a doctor delay in smear-negative patients (12,22). Referral delay: The referral intervals that exceeded two days were considered indicative of a referral delay in smear-negative and smear-positive patients (10,(20)(21)(22). Diagnosis delay: The diagnosis interval that exceed one day was considered indicative of a delayed diagnosis in smear-positive patients (10,20).…”

“…Referral delay: The referral intervals that exceeded two days were considered indicative of a referral delay in smear-negative and smear-positive patients (10,(20)(21)(22). Diagnosis delay: The diagnosis interval that exceed one day was considered indicative of a delayed diagnosis in smear-positive patients (10,20). Treatment delay: The treatment interval that exceed one day was defined as a delayed treatment (10,20,21).…”

“…Diagnosis delay: The diagnosis interval that exceed one day was considered indicative of a delayed diagnosis in smear-positive patients (10,20). Treatment delay: The treatment interval that exceed one day was defined as a delayed treatment (10,20,21). Clinical delay: While clinical intervals that exceeded two days were considered indicative of a clinic delay in smear-positive patients, a period of more than 13 days was indicative of a clinical delay in smear-negative patients (10,12,20,22).…”