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Referral times of Vietnamese refugees with tuberculosis in camps in Hong Kong

Authors: Taylor, W. R. J.1; Zumla, A.2

Source: The International Journal of Tuberculosis and Lung Disease, Volume 4, Number 4, April 2000 , pp. 350-355(6)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

SETTING: Two closed camps in Hong Kong for Vietnamese refugees.

OBJECTIVE: To determine the referral times by clinicians (doctor's delay) of cases of tuberculosis (TB) from refugee camp clinics to the hospital/chest clinic.

DESIGN: Retrospective case-note study of 97 Vietnamese patients receiving treatment for tuberculosis.

RESULTS: The sites of TB were pulmonary (n = 61), glandular (n = 15), pleural effusion (n = 15), and other (n = 6). The median referral time was 18 days (range 0–417). Median consultations numbered three (range 1–16). Fifty-three (54.6%) patients were prescribed antibiotics. Thirty-nine (40%) patients were referred within 10 days; of these, 18 were referred the same day. These 39 patients were less likely to have received antibiotics (9/39 [23.1%] vs 44/58 [75.9%], relative risk [RR] 0.3 95% confidence interval [CI] 0.17–0.55), but were equally likely to have been physically examined (RR 0.66, 95%CI 0.39–1.1). Sixteen (16.5%) patients were referred after 90 days. They attended the clinic more often (median attendances 6.5 vs 3, P = 0.0002), and were prescribed more antibiotic courses (mean antibiotic prescriptions 1.6 vs 0.7, P = 0.03).

CONCLUSION: Referral times by these clinicians varied widely, with long delays for approximately 60% of patients. Guidelines pertinent to primary care clinicians are needed to heighten their awareness of tuberculosis to prevent referral delays and subsequent TB treatment.

Keywords: Hong Kong; Vietnam; delay; refugees; tuberculosis

Document Type: Regular Paper

Affiliations: 1: The British Red Cross Society, Hong Kong 2: Centre for Infectious Diseases and International Health, Royal Free and University College Medical School, London, UK

Publication date: April 1, 2000

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  • 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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