BACKGROUND: Delayed diagnoses of pulmonary tuberculosis contribute to the spread of the epidemic. METHODS: This study aims to identify risk factors associated with patient delay (from symptoms onset to the first visit), health system delay (from the first visit to the tuberculosis treatment initiation) and total delay (sum of the patient and the health system delay) in low income and high tuberculosis burden countries. A systematic literature review has been performed using the keywords: "tuberculosis"; "delay", care seeking"; "health care seeking behavior"; "diagnosis" and "treatment". Only quantitative studies showing delays for pulmonary tuberculosis adult cases were included in this review. RESULTS: Low income, gender, rural life, unemployment, ageing and misunderstanding the microbial cause of tuberculosis are associated with delayed diagnoses. Systemic factors including low health care coverage, patient expenditures and entry into the health system by consulting a traditional healer or a non-skilled professional delay the beginning of tuberculosis treatment. CONCLUSION: Delays can be used as indicators to evaluate tuberculosis control programs. Active case finding in the households of contagious patients can help to diminish diagnostic delays in low-income countries with high endemicity.
BACKGROUND: Delayed diagnoses of pulmonary tuberculosis contribute to the spread of the epidemic. METHODS: This study aims to identify risk factors associated with patient delay (from symptoms onset to the first visit), health system delay (from the first visit to the tuberculosis treatment initiation) and total delay (sum of the patient and the health system delay) in low income and high tuberculosis burden countries. A systematic literature review has been performed using the keywords: "tuberculosis"; "delay", care seeking"; "health care seeking behavior"; "diagnosis" and "treatment". Only quantitative studies showing delays for pulmonary tuberculosis adult cases were included in this review. RESULTS: Low income, gender, rural life, unemployment, ageing and misunderstanding the microbial cause of tuberculosis are associated with delayed diagnoses. Systemic factors including low health care coverage, patient expenditures and entry into the health system by consulting a traditional healer or a non-skilled professional delay the beginning of tuberculosis treatment. CONCLUSION: Delays can be used as indicators to evaluate tuberculosis control programs. Active case finding in the households of contagious patients can help to diminish diagnostic delays in low-income countries with high endemicity.
Authors: Ndeindo Ndeikoundam Ngangro; Doudeadoum Ngarhounoum; Mosurel N Ngangro; Ngakoutou Rangar; Mahinda G Siriwardana; Virginie Halley des Fontaines; Pierre Chauvin Journal: BMC Public Health Date: 2012-07-09 Impact factor: 3.295
Authors: Peter D Massey; Rowena Asugeni; John Wakageni; Esau Kekeubata; John Maena'aadi; John Laete'esafi; Jackson Waneagea; Vunivesi Asugeni; David MacLaren; Richard Speare Journal: BMC Int Health Hum Rights Date: 2015-02-03
Authors: Kerri A Viney; Penelope Johnson; Markleen Tagaro; Saen Fanai; Nguyen N Linh; Paul Kelly; David Harley; Adrian Sleigh Journal: BMC Public Health Date: 2014-05-17 Impact factor: 3.295