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Int J Tuberc Lung Dis. 2010 Nov;14(11):1403-10.

Delay in diagnosis of pulmonary tuberculosis at a primary health clinic in Vitoria, Brazil.

Author information

1
Nucleo de Doenças Infecciosas, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil. emaciel@ndi.ufes.br

Abstract

SETTING:

Primary health clinics in Vitoria, Espirito Santo, Brazil.

OBJECTIVE:

To identify risk factors associated with patient and health care delays among patients seeking care at primary health clinics.

METHODS:

A prospective study among tuberculosis (TB) patients diagnosed in Vitoria between 1 January 2003 and 30 December 2007. A questionnaire ascertained the date of onset and duration of TB symptoms and medical records were reviewed. Between-group distributions of delay were compared and multivariate logistic regression was performed.

RESULTS:

Of 304 patients, 296 (97%) reported at least one TB symptom presenting for the first time to a qualified health service; 244 (80%) reported cough > 3 weeks. Median health care delay was 30 days (range 5-68), and median total delay was 110 days (range 26-784). Multivariate analysis revealed any cough (OR(adj) 7.35, 95%CI 2.40-22.5) and weight at TB diagnosis < 60 kg (OR(adj) 5.92, 95%CI 1.83-19.1) to be associated with patient delay of ≥ 30 days. Factors increasing risk of prolonged delay (≥ 90 days) were age ≥ 30 years (OR(adj) 1.93, 95%CI 1.09-3.43) and chest pain (OR(adj) 2.42, 95%CI 1.29-4.53).

CONCLUSION:

Improving health care workers' education regarding TB symptoms and implementing active case finding in targeted populations may reduce delays.

PMID:
20937179
PMCID:
PMC3697918
[Indexed for MEDLINE]
Free PMC Article

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