Assessment of Related Factors on Delay in Diagnosis of Patients with Smear-Positive Pulmonary Tuberculosis

Document Type : Original Article (s)

Authors

1 Department of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran

2 Assistant Professor, Health Sciences Research Center AND Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran

3 Deputy for Health, Hamadan University of Medical Sciences, Hamadan, Iran

4 Epidemiologist, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan AND PhD Student, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

5 Researcher, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences AND PhD Student, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: Approximately, one third of the world population is infected with tuberculosis (TB) germs and is put at risk of tuberculosis. Pulmonary tuberculosis accounts for more than 80 percent of cases, mostly in adults with positive sputum smear. The mortality and morbidity of the disease are associated with delay in diagnosis. Delay in diagnosis can be related to the patients or the health care system.Methods: In this historical cohort study, all the patients with smear-positive pulmonary tuberculosis in Hamadan province from 21 March 2006 to 20 March 2012 were studied. Data on demographic characteristics, and clinical and treatment status of patients were extracted using patient registry software entitled TB Register. To determine the relationship between variables and the bacillus load, chi-square test was used. The logistic regression model was used to examine the co-effects of both variables on bacillus load of the patients at the time of the diagnosis. Data were analyzed using Stata11 software.Findings: From 440 patients with smear-positive pulmonary tuberculosis, 51% (221 patients) were men and 49% (219 patients) were women. 57% (251 people) were living in urban and others in rural areas. The grade of sputum smear at the time of diagnosis was associated with area of residence, age group, and gender, that all were statistically significant. Delay in diagnosis among women, was approximately 0.55 of men and those in urban areas were 67% higher than in rural areas, which were both statistically significant.Conclusion: Individual factors play important role in delayed diagnosis, regarding that men are diagnosed later than the women. Screening programs in the workplace are recommended. Sensitization of private physicians would be effective in early identification of patients in urban areas.

Keywords

References

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Journal of Isfahan Medical School
Volume 33, Issue 332 - Serial Number 332
March and April 2015
Pages 596-603

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History

  • Receive Date: 15 November 2014
  • Revise Date: 05 May 2024
  • Accept Date: 06 April 2022

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