Delay in diagnosis of pulmonary tuberculosis at a primary health clinic in Vitoria, Brazil.
Int J Tuberc Lung Dis
; 14(11): 1403-10, 2010 Nov.
Article
em En
| MEDLINE
| ID: mdl-20937179
SETTING: Primary health clinics in Vitoria, Espirito Santo, Brazil. OBJECTIVE: To identify risk factors associated with patient and health care delays among patients seeking care at primary health clinics. METHODS: A prospective study among tuberculosis (TB) patients diagnosed in Vitoria between 1 January 2003 and 30 December 2007. A questionnaire ascertained the date of onset and duration of TB symptoms and medical records were reviewed. Between-group distributions of delay were compared and multivariate logistic regression was performed. RESULTS: Of 304 patients, 296 (97%) reported at least one TB symptom presenting for the first time to a qualified health service; 244 (80%) reported cough > 3 weeks. Median health care delay was 30 days (range 5-68), and median total delay was 110 days (range 26-784). Multivariate analysis revealed any cough (OR(adj) 7.35, 95%CI 2.40-22.5) and weight at TB diagnosis < 60 kg (OR(adj) 5.92, 95%CI 1.83-19.1) to be associated with patient delay of ≥ 30 days. Factors increasing risk of prolonged delay (≥ 90 days) were age ≥ 30 years (OR(adj) 1.93, 95%CI 1.09-3.43) and chest pain (OR(adj) 2.42, 95%CI 1.29-4.53). CONCLUSION: Improving health care workers' education regarding TB symptoms and implementing active case finding in targeted populations may reduce delays.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tuberculose Pulmonar
/
Tosse
/
Diagnóstico Tardio
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
/
Male
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Int J Tuberc Lung Dis
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Brasil
País de publicação:
França