Skip to main content

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

Download Article:
 Download
(PDF 255.93359375 kb)
 
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 (ORadj 7.35, 95%CI 2.40–22.5) and weight at TB diagnosis < 60 kg (ORadj 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 (ORadj 1.93, 95%CI 1.09–3.43) and chest pain (ORadj 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.
No References
No Citations
No Supplementary Data
No Article Media
No Metrics

Keywords: delayed diagnosis; epidemiology; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Nucleo de Doenças Infecciosas, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil 2: Johns Hopkins University School of Medicine, Baltimore, Maryland, USA 3: Yale University School of Medicine, New Haven, Connecticut, USA 4: Tuberculosis Control Program, Tuberculosis Control Program for the Vitoria City Secretary of Health, Vitoria, Espirito Santo, Brazil 5: Tuberculosis Control Program, Hospital Universitario Cassiano Antonio Moraes, Vitoria, Espirito Santo, Brazil

Publication date: 2010-11-01

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

  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • International Journal of Tuberculosis and Lung Disease
  • Public Health Action
  • Ingenta Connect is not responsible for the content or availability of external websites
  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more