Delay in diagnosis of Pulmonary Tuberculosis: Study of factors related to patients and health care system

Objective: To find factors related with delayed diagnosis of pulmonary tuberculosis in patients presenting to the hospitals of Rawalpindi. Methods: A cross sectional observation study was carried out in Benazir Bhutto Hospital, District head quarter Hospital, Fauji Foundation Hospital, Military Hospital and Holy Family Hospital, Rawalpindi from February 2016 to September 2016. A total of one hundred ninety patients of pulmonary tuberculosis were interviewed through convenient sampling by a formulated questionnaire. Results: Mean total delay was 114.48 days whereas median total delay was 53.5 days. Mean patient delay was 33.25 days and mean health care delay was 81.23 days. On multivariate analysis unemployment was associated with patients delay whereas healthcare delay was associated with smear negative TB and patients self-realization that there is delay in diagnosis. Conclusion: This study shows that there is a long delay in the diagnosis of pulmonary tuberculosis in our country. Unemployment is main factor related to patient delay. Improving TB knowledge and socio-economic status of individuals may help in the earlier diagnosis. Adequate training of healthcare workers in diagnosing smear negative TB and improvement in health care services may also help to reduce the long healthcare delays. J Microbiol Infect Dis 2017; 7(3):119-124