Determinants of delay in tuberculosis diagnosis in Hamadan province, 2006−2014

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• 作者：Salman Khazaei^a ; Mohammad Ali Mansournia^b ; Shahrzad Nematollahi^b ; ^{Shahrzadnema@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Erfan Ayubi^c ; Ali Zahiri^d ; Abdollah Mohamadian-Hafshejani^e ; Mahin Ahmadi Pishkuhi^f ; Hamid Salehiniya^g ; Somayeh khazaei^h
• 关键词：Tuberculosis ; Delayed diagnosis ; Iran
• 刊名：Egyptian Journal of Chest Diseases and Tuberculosis
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：65
• 期：4
• 页码：811-815
• 全文大小：415 K

文摘

Identifying factors that delay diagnosis of tuberculosis (TB) are important for the health system when timely patient treatment and reducing TB transmission are desirable goals. Aim of this study was to investigate the prognostic factors that delay TB diagnosis.

Material and methods

This retrospective cohort study used National TB Program (NTP) data from 1056 TB patients during 2006–2014 in Hamadan province, western Iran. The Cox regression model was performed to determine associations between baseline explanatory variables and survival outcome with Hazard Ratio HRs (95% CIs).

Results

N (%) of delay in TB diagnosis more than 90 days was significantly higher in male patients, new case patients and pulmonary positive cases. After adjustment for covariates, HR (95% CI) in relapsed TB compared to new cases was 0.67 (0.53, 0.85) and these figures for positive pulmonary cases and extra pulmonary cases in compared to negative pulmonary cases were 0.80 (0.68, 0.94) and 0.84 (0.73, 0.98) respectively.

Conclusion

A high proportion of patients had delays in diagnosis exceeding three months. Our findings suggest that male gender, new cases, positive and extra pulmonary cases might increase the risk for delayeddiagnosis among TB patients.