Determinants of delay in tuberculosis diagnosis in Hamadan province, 2006−2014

• Published in: The Egyptian journal of chest diseases and tuberculosis 2016-10, Vol.65 (4), p.811-815
• Main Authors: Khazaei, Salman, Mansournia, Mohammad Ali, Nematollahi, Shahrzad, Ayubi, Erfan, Zahiri, Ali, Mohamadian-Hafshejani, Abdollah, Ahmadi Pishkuhi, Mahin, Salehiniya, Hamid, khazaei, Somayeh
• Format: Article
• Language: English
• Subjects: Delayed diagnosis; Iran; Tuberculosis
• ISSN: 0422-7638
• DOI: 10.1016/j.ejcdt.2016.06.003

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. This 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). N (%) 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. A 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.