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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Demographic and clinical characteristics in relation to patient and health system delays in a tuberculosis low-incidence country
Scandinavian Journal of Infectious Diseases, Volume 44, No. 1, Year 2012
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Description
Background: Delays in the diagnosis and treatment of tuberculosis (TB) are commonly encountered. Methods: A study was undertaken among pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) patients in a Danish university hospital to describe demographic and clinical characteristics in relation to delay. Results: Of the 313 patients enrolled, 213 (68%) were diagnosed with PTB and 100 (32%) with EPTB only. Logistic regression analysis of EPTB showed an association with female sex and non-Danish ethnicity. Mean total delay from onset of symptoms until initiation of TB treatment was 123 (95% confidence interval (CI) 106-138) days. Mean patient delay was significantly longer than mean health system delay: 90 (95% CI 74-105) vs 33 (95% CI 23-44) days (p < 0.0001). Delay was independent of ethnicity and significantly shorter for PTB patients compared to EPTB patients. Fever was found to be strongly predictive of a short patient delay (<1 month), whereas weight loss was associated with a long patient delay (>3 months). In contrast, weight loss was associated with a short health system delay (<1 week). Elevated inflammatory markers were also associated with a short delay in the diagnosis of TB. Conclusions: This study confirmed a typical delay of months in duration in the diagnosis and treatment of TB in the low endemic country of Denmark. Increased TB awareness is needed, in particular in communities with immigrants originating from high-endemic areas. © 2012 Informa Healthcare.
Authors & Co-Authors
Leutscher, Peter Derek Christian
Denmark, Aarhus
Aarhus Universitetshospital
Erlandsen, Mogens
Denmark, Aarhus
Aarhus Universitet
Veirum, Jens Erik
Denmark, Aarhus
Aarhus Universitetshospital
Thomsen, Vibeke Østergaard
Denmark, Copenhagen
Statens Serum Institut
Wejse, Christian
Denmark, Aarhus
Aarhus Universitetshospital
Hilberg, Ole
Denmark, Aarhus
Aarhus Universitetshospital
Statistics
Citations: 27
Authors: 6
Affiliations: 3
Identifiers
Doi:
10.3109/00365548.2011.608081
ISSN:
16511980
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Approach
Quantitative
Participants Gender
Female