Delayed diagnosis of active pulmonary tuberculosis

Bibliographic Details
Main Author: Santos, João Almeida
Publication Date: 2021
Other Authors: Leite, Andreia, Soares, Patrícia, Duarte, Raquel, Nunes, Carla
Format: Article
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10362/129338
Summary: Funding Information: Fundação para a Ciência e Tecnologia provided financial support to conduct this research [Grant: PTDC/SAU-PUB/31346/2017]. Publisher Copyright: © 2021, The Author(s).
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spelling Delayed diagnosis of active pulmonary tuberculosispotential risk factors for patient and healthcare delays in PortugalHealthcare delayPatient delayPublic healthPulmonary tuberculosisTotal delayTuberculosis controlPublic Health, Environmental and Occupational HealthSDG 3 - Good Health and Well-beingFunding Information: Fundação para a Ciência e Tecnologia provided financial support to conduct this research [Grant: PTDC/SAU-PUB/31346/2017]. Publisher Copyright: © 2021, The Author(s).Background: Early diagnosis and treatment of pulmonary tuberculosis (PTB) is essential for an effective control of the tuberculosis (TB) epidemic. Delayed diagnosis and treatment of TB increases the chance of complications and mortality for the patients, and enhances TB transmission in the population. Therefore, the aim of this study was to characterize patient, healthcare and total delay in diagnosing PTB and assess the effect of clinical and sociodemographic factors on the time until first contact with healthcare or reaching a PTB diagnosis. Methods: Retrospective cohort study that included active PTB patients notified in the National Tuberculosis Surveillance System (SVIG-TB), between 2008 and 2017. Descriptive statistics, Kaplan-Meier estimates, logrank test and Cox proportional hazards model were used to characterize patient, healthcare and total delay and estimate the effect of clinical and sociodemographic variables on these delays. Significance level was set at 0.05. Results: Median patient, healthcare and total delays was 37 days (Interquartile range (IQR): 19–71), 8 days (IQR: 1–32) and 62 days (IQR: 38–102), respectively. The median patient delay showed a constant increase, from 33 days in 2008 to 44 days in 2017. The median total delay presented a similar trend, increasing from 59 days in 2008 to 70 days in 2017. Healthcare delay remained constant during the study period. More than half of the PTB cases (82.9%) had a delay > 1 month between symptom onset and diagnosis. In the final Cox model, alcohol abuse, unemployment and being from a high TB incidence country were factors significantly associated with longer patient delay, while being female, having more than 45 years, oncologic and respiratory diseases were associated with longer healthcare delay. Being female, having more than 45 years and being from a high TB incidence country were associated with longer total delay. Conclusions: Patient delay and total delay have increased in recent years. Older patients, patients with alcohol problems, other comorbidities, unemployed or from countries with high TB incidence would benefit from the development of specific public health strategies that could help reduce the delay in TB diagnosis observed in our study. This study emphasizes the need to promote awareness of TB in the general population and among the healthcare community, especially at ambulatory care level, in order to reduce the gap between beginning of symptoms and TB diagnosis.Comprehensive Health Research Centre (CHRC) - Pólo ENSPCentro de Investigação em Saúde Pública (CISP/PHRC)Escola Nacional de Saúde Pública (ENSP)RUNSantos, João AlmeidaLeite, AndreiaSoares, PatríciaDuarte, RaquelNunes, Carla2021-12-16T23:39:38Z2021-122021-12-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/129338engPURE: 35415785https://doi.org/10.1186/s12889-021-12245-yinfo:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2024-05-22T17:57:37Zoai:run.unl.pt:10362/129338Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T17:28:52.395441Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Delayed diagnosis of active pulmonary tuberculosis
potential risk factors for patient and healthcare delays in Portugal
title Delayed diagnosis of active pulmonary tuberculosis
spellingShingle Delayed diagnosis of active pulmonary tuberculosis
Santos, João Almeida
Healthcare delay
Patient delay
Public health
Pulmonary tuberculosis
Total delay
Tuberculosis control
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
title_short Delayed diagnosis of active pulmonary tuberculosis
title_full Delayed diagnosis of active pulmonary tuberculosis
title_fullStr Delayed diagnosis of active pulmonary tuberculosis
title_full_unstemmed Delayed diagnosis of active pulmonary tuberculosis
title_sort Delayed diagnosis of active pulmonary tuberculosis
author Santos, João Almeida
author_facet Santos, João Almeida
Leite, Andreia
Soares, Patrícia
Duarte, Raquel
Nunes, Carla
author_role author
author2 Leite, Andreia
Soares, Patrícia
Duarte, Raquel
Nunes, Carla
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Comprehensive Health Research Centre (CHRC) - Pólo ENSP
Centro de Investigação em Saúde Pública (CISP/PHRC)
Escola Nacional de Saúde Pública (ENSP)
RUN
dc.contributor.author.fl_str_mv Santos, João Almeida
Leite, Andreia
Soares, Patrícia
Duarte, Raquel
Nunes, Carla
dc.subject.por.fl_str_mv Healthcare delay
Patient delay
Public health
Pulmonary tuberculosis
Total delay
Tuberculosis control
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
topic Healthcare delay
Patient delay
Public health
Pulmonary tuberculosis
Total delay
Tuberculosis control
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
description Funding Information: Fundação para a Ciência e Tecnologia provided financial support to conduct this research [Grant: PTDC/SAU-PUB/31346/2017]. Publisher Copyright: © 2021, The Author(s).
publishDate 2021
dc.date.none.fl_str_mv 2021-12-16T23:39:38Z
2021-12
2021-12-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/129338
url http://hdl.handle.net/10362/129338
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv PURE: 35415785
https://doi.org/10.1186/s12889-021-12245-y
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
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