Skip to main content

Free Content Factors associated with patient and health care system delay in the diagnosis of tuberculosis in France

Download Article:
 Download
(PDF 257.5439453125 kb)
 
OBJECTIVE: To analyse diagnostic delay in tuberculosis (TB) patients.

DESIGN: Cross-sectional study: all patients with TB notified to the French national surveillance system from April to June 2010 were interviewed face-to-face using a standardised questionnaire to assess symptom history and health-seeking trajectories.

RESULTS: Of 225 patients enrolled, 172 (76.4%) had pulmonary TB, including 88 who were smear-positive. Mean delay between first symptoms and diagnosis (total delay) was 97 days (median 68, IQR 33–111), with a mean of 47 days (median 14, IQR 0–53) between first symptoms and health care contact (patient delay), and 48 days (median 25, IQR 6–67) between health care contact and diagnosis (health system delay). Factors independently associated with shortened total delay were medical insurance (OR 0.24, P = 0.014) and previous TB (OR 0.28, P = 0.049). Those associated with reduced patient delay were initial fever (OR 0.42, P = 0.03) and being followed by a general practitioner (OR 0.22, P = 0.004), while those associated with reduced health system delay were first health care contact within a hospital (OR 0.15, P < 0.001). Empirical antibiotic treatment was associated with increased health system delay (OR 4.4, P = 0.001).

CONCLUSION: TB diagnostic delay needs to be reduced in France. This may be achieved through improved access to care, earlier hospital referral, and less use of empirical antibiotic treatment.
No References
No Citations
No Supplementary Data
No Article Media
No Metrics

Keywords: France; diagnosis delay; empirical antibacterials; health care system; tuberculosis

Document Type: Research Article

Affiliations: 1: Unité des Maladies Infectieuses et Réanimation Médicale, CHU Pontchaillou, Rennes, France 2: Institut de Veille Sanitaire, Saint-Maurice, France 3: Réseau des Centres de Lutte Anti-Tuberculeuse, Strasbourg, France 4: Unité des Maladies Infectieuses et Tropicales, Hôpital Bichat, Paris, France 5: Direction Générale de la Santé, Paris, France

Publication date: 2012-04-01

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