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Free Content Pulmonary tuberculosis: diagnostic delay in Ghanaian adults

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Abstract:

Setting: Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana, West Africa.

Objective: To determine the factors affecting the delay from the onset of symptoms of pulmonary tuberculosis until the initiation of treatment.

Design: A retrospective questionnaire survey of 100 adults with newly diagnosed smear-positive pulmonary tuberculosis.

Results: The median total delay in diagnosis was 4 months (mean = 7.7), and total delay exceeded 6 months in 44% of patients. Total delay was strongly associated with rural residence (P = 0.001). The median doctor delay from the first consultation until diagnosis was double the median patient delay in initial presentation (8 weeks versus 4 weeks). Doctor delay was significantly increased in females, rural patients, and among those needing hospital admission. Increased doctor delay was strongly correlated with rates of failure to perform sputum microscopy (r = 0.99), low rates of diagnosis, and was seen particularly among private practitioners and rural government institutions.

Conclusion: Delays in the diagnosis of pulmonary tuberculosis are prolonged in Kumasi, Ghana, with a frequently lengthy doctor delay. The new National Tuberculosis Programme is decentralising the diagnosis and management of tuberculosis, with the introduction of widely available sputum microscopy and rigorous training of health personnel. This should help to reduce doctor delay and thereby improve tuberculosis control.

Keywords: Africa; delay; diagnosis; tuberculosis

Document Type: Regular Paper

Affiliations: 1: The Department of Medicine, School of Medical Sciences, University of Science and Technology, Kumasi, Ghana, West Africa; and Division of Infectious Diseases, St George's Hospital Medical School, London, UK 2: The Department of Medicine, School of Medical Sciences, University of Science and Technology, Kumasi, Ghana, West Africa

Publication date: August 1, 1998

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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