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Factors affecting delays in diagnosis and treatment of pulmonary tuberculosis in a tertiary care hospital in Istanbul, Turkey

To investigate delays in the diagnosis and treatment of inpatients with smear-positive pulmonary tuberculosis and to identify factors affecting these delays. Materials/Methods: 204 hospitalized patients with smear-positive pulmonary tuberculosis were identified. The clinical files of the patients were analyzed and questionnaires were created. Results: Mean application interval was 31.4 days, mean referral interval was 22.1 days, mean diagnosis interval was 3.3 days, and mean initiation of treatment interval was 1.4 days. Patient delay was present in 34.8 percent of the patients. The application interval was shorter for patients having an index case for tuberculosis (p=0.039) and for those with good economic status (p. | Med Sci Monit 2004 10 2 CR62-67 PMID 14737045 www.MEDSCIMONIT.com Clinical Research Received 2002.11.07 Accepted 2003.07.03 Factors affecting delays in diagnosis and treatment Published 2004.02.01 of pulmonary tuberculosis in a tertiary care hospital in Istanbul Turkey Authors Contribution Study Design Data Collection Dondu Guneylioglu bf Adnan Yilmazaccd Sevinc Bilginbf Ummuhan Bayram bf Esen Akkaya ace Q Statistical Analysis Data Interpretation Manuscript Preparation Department of Pulmonology SSK Sureyyapa a Center for Chest Diseases and Thoracic Surgery Istanbul-Turkey Literature Search IB Funds Collection Source of support none. Summary Background To investigate delays in the diagnosis and treatment of inpatients with smear-positive pulmonary tuberculosis and to identify factors affecting these delays. Materials Methods 204 hospitalized patients with smear-positive pulmonary tuberculosis were identified. The clinical files of the patients were analyzed and questionnaires were created. Results Mean application interval was 31.4 days mean referral interval was 22.1 days mean diagnosis interval was 3.3 days and mean initiation of treatment interval was 1.4 days. Patient delay was present in 34.8 percent of the patients. The application interval was shorter for patients having an index case for tuberculosis p 0.039 and for those with good economic status p 0.005 . 167 patients 81.9 had institutional delay. The referral interval was longer for female patients than for male patients p 0.015 . The most common causes of institutional delays were a low index of suspicion for tuberculosis health care system delays and underutilized chest X-ray examinations. One hundred and three patients 50.5 had delays in diagnosis and 51 patients 25.0 had delays in treatment. The most frequent reason for diagnostic delay was health care system delays 35.9 . Conclusions There were several delays in the diagnosis of tuberculosis patients. For an effective tuberculosis control efforts .