Delays in the diagnosis of pulmonary tuberculosis in Coahuila, Mexico

作者：Salinas J; Calvillo S; Cayla J; Nedel F B; Martin M; Navarro A^*

来源：International Journal of Tuberculosis and Lung Disease, 2012, 16(9): 1193-1198.

DOI：10.5588/ijtld.11.0476

• pulmonary TB
• delay
• diagnosis

OBJECTIVE: To determine diagnostic delay in pulmonary tuberculosis (PTB) cases and analyse associated factors. %26lt;br%26gt;METHODS: New PTB cases were studied in Coahuila, Northern Mexico, between 2008 and 2009. We obtained census data and data on residential address, symptoms and diagnosis from the national patient database; socio-demographic variables were obtained during home visits. Bivariate analyses used the Kaplan-Meier method; multivariate analysis consisted of modelling survival. %26lt;br%26gt;RESULTS: We studied 458 subjects (median age 48 years), who were predominantly males (56.1%); the median years of schooling was 6.0 years, 83.4% were urban residents, 50.3% were unemployed, and 87.7% suffered from food poverty. The median delay between the on! et of symptoms and the first medical consultation was 53.5 days. Lack of formal education (P = 0.050) and living %26gt;= 5 km from a health unit (P = 0.034) were associated with longer delays and consequently with severe symptoms (cough %26gt;= 2 weeks, P = 0.001; chest pain, P = 0.032; malnutrition, P = 0.003). Mean health system delay (between first consultation and smear test result) was 18.5 days, and was significantly longer when the first consultation was with a private physician (P %26lt; 0.001) and when patient age was %26gt;= 46 years (P = 0.001). %26lt;br%26gt;CONCLUSIONS: In Coahuila, lack of formal education, living %26gt;= 5 km from a health unit, first consultation with a private physician, and being aged %26gt;= 46 years contributed to delays in PTB diagnosis.

• 出版日期2012-9