Pulmonary tuberculosis: Diagnostic delay in Tunisia

Amar, J. Ben; Hassairi, Moez; Salah, Nesrine Ben; Charfi, Rim; Tritar, F.; Fourati, R; Gamara, Dhikrayet; Aouina, H.; Bouacha, H.

doi:10.1016/j.medmal.2015.11.012

Cited by 14 publications

(9 citation statements)

References 13 publications

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“…In agreement with previous studies, risk factors such as being a male, being employed, visiting health care facilities ≥3 times, and attending public hospitals (government hospitals) for the first time prior to diagnosis of TB were attributed to an increased PD [ 1 , 15 , 56 – 58 ]. Attending public hospitals was a risk factor for PD possibly because public hospitals are associated with prolonged waiting times, a high number of patients with diverse diseases, and lack of an adequate number of trained physicians.…”

Section: Discussionsupporting

confidence: 90%

The identification of risk factors associated with patient and healthcare system delays in the treatment of tuberculosis in Tabriz, Iran

et al. 2018

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BackgroundTuberculosis (TB) is a serious health concern, particularly in developing countries. Various delays, such as patient delay (PD) and healthcare system delay (HSD) in the TB process, are exacerbating the disease burden and increasing the rates of transmission and mortality in various global communities. Therefore, the aim of this study is to identify risk factors associated with PD and HSD in TB patients in Tabriz, Iran.MethodsA cross-sectional study was conducted on 173 TB patients in Tabriz, Iran from 2012 to 2014. Patients were interviewed with a semi-structured questionnaire. Frequencies and percentages were reported for patient categories of sex, age, and education. The median and interquartile range (IQR) were reported for the time intervals of delays. Univariate and multivariate logistic regressions of delay in respect to socio-demographic and clinical variables were performed. Statistical significance was set at p < 0.05.ResultsThe median values for delays were 53 days for HSD (IQR = 73) and 13 days for PD (IQR = 57). Odds ratios (OR) associated with PD were: employed vs. unemployed (OR = 5.86, 95% CI: 1.59 to 21.64); public hospitals vs. private hospitals (OR = 2.64, 95% CI: 1.01 to 6.85); ≥ 3 vs. < 3 visits to health facilities before correct diagnosis (OR = 2.35, 95% CI: 1.08 to 5.11); and male vs. female (OR = 2.28, 95% CI: 1.29 to 4.39). The OR associated with HSD were: ≥ 3 vs. < 3 visits to health facilities before correct diagnosis (OR = 9.44, 95% CI: 4.50 to 19.82), without vs. with access to TB diagnostic services (OR = 3.56, 95% CI: 1.85 to 6.83), and misdiagnosis as cold or viral infection vs. not (OR = 2.62, 95% CI: 1.40 to 4.91).ConclusionsThe results provide for an important understanding of the risk factors associated with PD and HSD. One of the major recommendations is to provide more TB diagnostic knowledge and tools to primary health providers and correct diagnoses for patients during their initial visit to the health care facilities. The knowledge generated from this study will be helpful for prioritizing and developing strategies for minimizing delays, initiating early treatment to TB patients, and improving TB-related training programs and healthcare systems in Tabriz, Iran.

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Section: Discussionsupporting

confidence: 90%

The identification of risk factors associated with patient and healthcare system delays in the treatment of tuberculosis in Tabriz, Iran

et al. 2018

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“…The median duration from onset of TB symptoms to diagnosis in our study was 34 days, which is comparable to the 30 days reported from a study in Ethiopia ( Fuge et al, 2018 ). This duration in our study is however shorter than durations in excess of 45 days reported from studies in Angola, Tunisia and Brazil ( Ben Amar et al, 2016 , Machado et al, 2011 , Segagni Lusignani et al, 2013 ). In contrast to our study, these studies included patients with smear-negative TB, extra-pulmonary TB and culture-positive TB disease, which could explain the longer duration from onset of TB symptoms to diagnosis.…”

Section: Discussioncontrasting

confidence: 79%

“…We did not find any association between gender, marital status, having formal education and TB diagnostic delay. Other studies had reported that female gender was associated with TB diagnostic delay ( Ben Amar et al, 2016 , Cai et al, 2015 , Ndeikoundam Ngangro et al, 2012 , Peri et al, 2018 , Saldana et al, 2013 ).…”

Section: Discussionmentioning

confidence: 92%

Delay in the diagnosis of pulmonary tuberculosis in The Gambia, West Africa: A cross-sectional study

Owolabi

Jallow

et al. 2020

International Journal of Infectious Diseases

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Highlights Provision of high quality of TB care is crucial for the End TB Strategy. COVID-19 pandemic will have grave consequences for TB patients. Delay in diagnosis of TB is a surrogate of quality of TB care. There is considerable delay in the diagnosis of TB in The Gambia. Need for better understanding of patient pathways to care.

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“…People who experience signs and symptoms of TB should report promptly for formal diagnosis in TB clinics. Unfortunately, in many low‐to‐middle income countries that have a high TB burden, a diagnosis delay is still common. The underlying reasons reflect factors related to patients and the healthcare system.…”

Section: Discussionmentioning

confidence: 99%

Hyperglycemia is associated with increased risk of patient delay in pulmonary tuberculosis in rural areas

Wang

Han

et al. 2016

Journal of Diabetes

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Pulmonary tuberculosis: Diagnostic delay in Tunisia

Cited by 14 publications

References 13 publications

The identification of risk factors associated with patient and healthcare system delays in the treatment of tuberculosis in Tabriz, Iran

The identification of risk factors associated with patient and healthcare system delays in the treatment of tuberculosis in Tabriz, Iran

Delay in the diagnosis of pulmonary tuberculosis in The Gambia, West Africa: A cross-sectional study

Hyperglycemia is associated with increased risk of patient delay in pulmonary tuberculosis in rural areas

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