survey of behavioral and non behavioral factors related to delayed diagnosis of pulmonary tuberculosis in east azerbaijan

Abstract

Aim and Background: Tuberculosis is an important challenge in health systems. Delays in the diagnosis of tuberculosis may result in increased patient morbidity and in further spread of the disease. Therefore, early diagnosis and immediate initiation of treatment are required for an effective tuberculosis (TB) control program. This study investigated thebehaivioral and non behavioral factores that effected on length of delay between the onset of symptoms and patients first visit to health care (patient delay), and the length of delay between health care visit and the diagnosis of tuberculosis (health service delay). Materials and Methods: A descriptive-analytical research was undertaken between July 2010 and June 2013 on 85 patients with ≥ 3 smears in East-Azerbaijan. For gathering related data pulmonary TB patients with history of delay in the diagnosis of tuberculosis were interviewed using structured questionnaire. Findings: 85 pulmonary TB patients (39(45.9) male, 46(54.1) females) were studied.The mean age was (22.69 years).Mean and SD of total delay was 172.80(126.20) with median of 150 days. The mean and SD of system and patient’s delay were 125.58(126.20) with median 60 days and 73.47(63.53) with median of 60 days respectivly. No significant relationship between delays and variables such as age, gender, education status, job, marital status and living place revealed. Conclusion: This research confirmed that the time before diagnosis in health service was long and appears to be associated with lack of the physicians' sensitivity in differential diagnosis of TB. Patient had inadequate knowledge of frre treatment which delivers in public health centers. Furthermore, early diagnosis had been diagnosed in private sectors. Raising public awareness of the disease to increase public service utilization as well as integration public health centers with private sector health are recommended in order to reduce diagnostic delay.