Open AccessDeterminants of delay in tuberculosis diagnosis in Hamadan province, 2006−2014
Author(s) -
Salman Khazaei,
Mohammad Alì Mansournia,
Shahrzad Nematollahi,
Erfan Ayubi,
Ali Zahiri,
Abdollah Mohamadian-Hafshejani,
Mahin Ahmadi Pishkuhi,
Hamid Salehiniya,
Somayeh Khazaei
Publication year - 2016
Publication title -
egyptian journal of chest diseases and tuberculosis/egyptian journal of chest diseases and tuberculosis
Language(s) - English
Resource type - Journals
eISSN - 2090-9950
pISSN - 0422-7638
DOI - 10.1016/j.ejcdt.2016.06.003
Subject(s) - medicine , pulmonary tuberculosis , proportional hazards model , hazard ratio , tuberculosis , retrospective cohort study , cohort , pediatrics , surgery , confidence interval , pathology
Identifying factors that delay diagnosis of tuberculosis (TB) are important for the health system when timely patient treatment and reducing TB transmission are desirable goals. Aim of this study was to investigate the prognostic factors that delay TB diagnosis.Material and methodsThis retrospective cohort study used National TB Program (NTP) data from 1056 TB patients during 2006–2014 in Hamadan province, western Iran. The Cox regression model was performed to determine associations between baseline explanatory variables and survival outcome with Hazard Ratio HRs (95% CIs).ResultsN (%) of delay in TB diagnosis more than 90 days was significantly higher in male patients, new case patients and pulmonary positive cases. After adjustment for covariates, HR (95% CI) in relapsed TB compared to new cases was 0.67 (0.53, 0.85) and these figures for positive pulmonary cases and extra pulmonary cases in compared to negative pulmonary cases were 0.80 (0.68, 0.94) and 0.84 (0.73, 0.98) respectively.ConclusionA high proportion of patients had delays in diagnosis exceeding three months. Our findings suggest that male gender, new cases, positive and extra pulmonary cases might increase the risk for delayeddiagnosis among TB patients