International Journal of Infectious Diseases (Jan 2025)
Disparities in tuberculosis diagnostic delays between native and migrant populations in Italy: A multicenter study
- Francesco Di Gennaro,
- Sergio Cotugno,
- Giacomo Guido,
- Francesco Cavallin,
- Mariantonietta Pisaturo,
- Lorenzo Onorato,
- Federica Zimmerhofer,
- Luca Pipitò,
- Giuseppina De Iaco,
- Giuseppe Bruno,
- Massimo Fasano,
- Agostina Pontarelli,
- Annarita Botta,
- Tiziana Iacovazzi,
- Rossana Lattanzio,
- Virginia Di Bari,
- Gianfranco Panico,
- Raffaella Libertone,
- Caterina Monari,
- Alessia Musto,
- Mariangela Niglio,
- Federica De Gregorio,
- Loredana Alessio,
- Gina Gualano,
- Salvatore Minniti,
- Giovanni Battista Buccoliero,
- Teresa Santantonio,
- Sergio Lo Caputo,
- Sergio Carbonara,
- Antonio Cascio,
- Roberto Parrella,
- Fabrizio Palmieri,
- Nicola Coppola,
- Annalisa Saracino
Affiliations
- Francesco Di Gennaro
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, BA, Italy
- Sergio Cotugno
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, BA, Italy; Corresponding author: Sergio Cotugno, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Piazza Giulio Cesare 11, Bari 70124, Italy.
- Giacomo Guido
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, BA, Italy
- Francesco Cavallin
- Independent Statistician, Solagna, Italy
- Mariantonietta Pisaturo
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
- Lorenzo Onorato
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
- Federica Zimmerhofer
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D'Alessandro”, Infectious and Tropical Disease Unit, University of Palermo, Palermo, Italy
- Luca Pipitò
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D'Alessandro”, Infectious and Tropical Disease Unit, University of Palermo, Palermo, Italy
- Giuseppina De Iaco
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, BA, Italy
- Giuseppe Bruno
- Infectious Disease Department, Saint Giuseppe Moscati Hospital, Taranto, TA, Italy
- Massimo Fasano
- UOC Malattie Infettive, ASL BA, PO Della Murgia “Fabio Perinei”, Altamura, BA, Italy
- Agostina Pontarelli
- Respiratory Infectious Disease Unit, AORN dei Colli, Cotugno Hospital, Naples, NA, Italy
- Annarita Botta
- Respiratory Infectious Disease Unit, AORN dei Colli, Cotugno Hospital, Naples, NA, Italy
- Tiziana Iacovazzi
- UOC Malattie Infettive, ASL BA, PO Della Murgia “Fabio Perinei”, Altamura, BA, Italy
- Rossana Lattanzio
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, BA, Italy
- Virginia Di Bari
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, RM, Italy
- Gianfranco Panico
- UOC Malattie Infettive, Ospedale Vittorio Emanuele II, ASL BT, Bisceglie, BT, Italy
- Raffaella Libertone
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, RM, Italy
- Caterina Monari
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
- Alessia Musto
- UOC Malattie Infettive, Ospedale Antonio Perrino, Brindisi, BR, Italy
- Mariangela Niglio
- Department of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia, Foggia, FG, Italy
- Federica De Gregorio
- Department of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia, Foggia, FG, Italy
- Loredana Alessio
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
- Gina Gualano
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, RM, Italy
- Salvatore Minniti
- UOC Malattie Infettive, Ospedale Antonio Perrino, Brindisi, BR, Italy
- Giovanni Battista Buccoliero
- Infectious Disease Department, Saint Giuseppe Moscati Hospital, Taranto, TA, Italy
- Teresa Santantonio
- Department of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia, Foggia, FG, Italy
- Sergio Lo Caputo
- Department of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia, Foggia, FG, Italy
- Sergio Carbonara
- UOC Malattie Infettive, Ospedale Vittorio Emanuele II, ASL BT, Bisceglie, BT, Italy
- Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D'Alessandro”, Infectious and Tropical Disease Unit, University of Palermo, Palermo, Italy
- Roberto Parrella
- Respiratory Infectious Disease Unit, AORN dei Colli, Cotugno Hospital, Naples, NA, Italy
- Fabrizio Palmieri
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, RM, Italy
- Nicola Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
- Annalisa Saracino
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, BA, Italy
- Journal volume & issue
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Vol. 150
p. 107279
Abstract
Background: Tuberculosis (TB) remains a Global Health challenge, with diagnostic delays contributing significantly to its spread. This study investigates the differences in diagnostic delays between native and migrant TB patients in Italy, examining patient-related diagnostic delay (PDD), health system-related diagnostic delay (HDD), and total diagnostic delay (TDD). Methods: We conducted a retrospective, multicenter, cross-sectional study of TB cases in 10 Italian hospitals from 2018 to 2023. We compared PDD, HDD, and TDD between native and migrant populations. Socio-demographic data and clinical histories were analyzed to identify factors contributing to diagnostic delays. Results: We included 669 TB patients (390 migrants and 279 natives). Migrants experienced significantly longer PDD (median 90 vs 10 days, P < 0.0001) but shorter HDD (median 5 vs 40 days, P < 0.0001) compared to natives, resulting in a longer TDD (median 96 vs 65 days, P < 0.0001). Furthermore, migrants had higher Timika scores, longer sputum conversion times, and were more frequently lost to follow-up. Conclusion: Migrants face longer PDD, emphasizing substantial barriers to healthcare access. Natives experience longer HDD, reflecting neglect of TB in low-endemic regions. Future research should focus on the impact of social determinants and training for healthcare providers on TB diagnosis and develop strategies to reduce diagnostic delays.
