Diagnosis delay in smear positive tuberculosis patients

Abstract

• BACKGROUND: Early diagnosis of tuberculosis (TB) is a major key for effective TB program. Evaluation of delay in diagnosis of smear positive TB is needed to evaluation of TB program situation in each country. The aim of this study was to evaluate of diagnosis delay in smear positive tuberculosis patients in Islamic Republic of Iran. 
• MATERIALS AND METHODS: In this cross sectional study, all smear positive TB registered patients from 20 March 2009 to 20 March 2010 in Iran were assessed. Diagnosis delay is defined as the time interval between the first presentations of TB symptoms to the TB confirmation. Mann-Whitney test, chi-square and logistic regression was used to analysis.
•  RESULTS: Diagnosis delay was 58 days in female and 53 days in male (P=0.004), 61 days in non-Iranian and 54 days in Iranian (P<0.001), 59 days in urban and 50 days in rural (P<0.001), 57 days in non-prisoner and 37 days in prisoner (P<0.001), 61 days in patients who chose private outpatients system and 52 days in patients who chose Public health outpatients system (P<0.001). 193 (9.4%) had 1-9 bacilli and 2132 (37.4%) were 3+ in sputum smear examination.
•  CONCLUSION: Non-Iranian, urban, non-prisoner, old patients and the patients who chose private system are in risk of delay diagnosis of TB. Cooperation of private system through public-private mix model is an important key in successful national TB program (NTP).
• Key words: Diagnosis delay, public private mix, tuberculosis