Variables associated with diagnostic delay in immigrant groups with tuberculosis in Madrid
Authors: Sanz, B.; Blasco, T.
Source: The International Journal of Tuberculosis and Lung Disease, Volume 11, Number 6, June 2007 , pp. 639-646(8)
Abstract:OBJECTIVE: To identify variables associated with total diagnostic delay (TDD), patient delay (PD) and health service delay (HSD), among the tuberculous immigrant population in the Autonomous Community of Madrid (ACT).
METHODOLOGY: Tuberculosis cases diagnosed in 15 hospitals in the ACT in 2003 were interviewed face-to-face and medical records were reviewed. A descriptive study was conducted, followed by univariate and multivariate analysis using non-conditional logistic regressions. 50th (p50) and 75th (p75) percentiles of the different diagnostic delay components were analysed as dependent variables.
RESULTS: For the 296 cases included, the mean TDD was 40.5 days (IQR 16.0–90.0), the PD was 15 days (IQR 6.5–30.0), and the HSD was 5 days (IQR 0.0–30.0). TDD-p75 is associated with seeking primary health care (OR 2.87, 95%CI 1.47–5.58). PD-p75 is associated with identification of fever (OR 0.49, 95%CI 0.25–0.92) and non-identification of cough (OR 1.87, 95%CI 1.05–3.36) as symptoms resulting in health care being sought. The HSD-p75 is associated with primary health care being sought (OR 3.81, 95%CI 1.87–7.78), health cover (OR 15.07, 95%CI 1.96–115.68) and negative smear results at the time of diagnosis (OR 1.98, 95%CI 1.01–3.91).
CONCLUSIONS: The HSD needs to be reduced, mainly when health care is sought through the primary care services and among patients with negative smear results.
Document Type: Regular Paper
Affiliations: National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain
Publication date: June 1, 2007
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