Hurdle in the eradication of tuberculosis: delay in diagnosis

Abstract

Objective Identifying the factors responsible for the delay in the diagnosis of tuberculosis (TB). Patients and methods In this retrospective study, data on pulmonary and extrapulmonary forms of TB, registered for the treatment at the directly observed treatment, short course, centre were analysed. Results Of 163 patients, 34 (20.86%) were diagnosed at the first visit. The delay in seeking medical care ranged from 0 to 25 days from the diagnosis. A total of 110 (67%) patients started on the same day or the day after diagnosis, less than 1 month in 33 (20.25%) and 1–3 months in 83 (51%). Delay from patient and health services (both combined) ranged from half a month to 48 months; the mean±SD diagnostic delay was 4.09±4.19 days (range: 0–24 days), whereas the mean±SD treatment delay (n=162) was 2.19±3.89 days. of the 124 patients who received medical help, 90% of them did so within six months of onset of Symptoms. There was a statistically significant difference in patients’ delay in receiving the treatment/medical care by sex. Mean±SD delay for pulmonary and extrapulmonary TB was 48±24 and 240±386 days, respectively. Conclusion Delay in diagnosis is a preventable factor. Patient delay is longer compared with healthcare delays. Active surveillance, even in the urban areas by healthworkers, may help in reducing this delay.

Keywords

• delay in diagnosis
• extrapulmonary tuberculosis
• patient delay
• pulmonary tuberculosis
• treatment delay