Source: Annual Congress 2008 - Diagnosis of tuberculosis: problems and perspectives
Disease area: Respiratory infections

Abstract

Background: Delay in diagnosis and treatment of tuberculosis leads to severe disease with a higher mortality and longer period of infectivity in the community.
Study on patient delay (time interval from onset of symptoms to first visit of a health care provider) and health system delay (time interval from first visit and start of treatment) can help policies to improve control of TB.
Aims: This study performed to measure patient and health system delay in tuberculosis cases and to evaluate the associated risk factors in a referral TB center in Iran.
Methods: A total of 944 newly diagnosed TB patients were interviewed using a structured questionnaire from May 2003 to Sep 2006 were included.
Delays were divided into patient and health care system. The association with sex, age, nationality, socioeconomic state, habit, close contact, symptoms, HIV status, drug resistance and outcome of treatment was investigated.
Results: The mean diagnostic delays were as follows: total delay 138.4 days (median 90.0); patient delay 9.8 days (median 0.00); health service delay 128.5 days (median 90.0).
Risk factors for patient delay were early age, male sex, educational level lower than university, smoking, alcohol consumption, addiction, and crowded family.
Health system delay was significant longer for patients with old age, residents in rural area, non smokers, non alcoholic and non addicts.
Conclusions: Delay in the diagnosis and treatment of pulmonary TB is unacceptably high in Iran. Public health interventions should be performed for education of the general public and health care workers on tuberculosis and further attention to smokers, alcoholics and addicts is necessary.

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Citations should be made in the following way:
M. Marjani, P. Tabarsi, P. Baghaei, M. Shamaei, M. Kazempour, D. Mansouri, M. R. Masjedi (Tehran, Islamic Republic Of Iran). Patient and health system delay among new cases of tuberculosis in a referral hospital in Iran. Eur Respir J 2008; 32: Suppl. 52, 2377

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