Assessment of Related Factors on Delay in Diagnosis of Patients with Smear-Positive Pulmonary Tuberculosis

Background: Approximately, one third of the world population is infected with tuberculosis (TB) germs and is put at risk of tuberculosis. Pulmonary tuberculosis accounts for more than 80 percent of cases, mostly in adults with positive sputum smear. The mortality and morbidity of the disease are ass...

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Main Authors: Salman Khazaei, Ghodratollah Roshanaei, Zahra Kousehlou, Ali Zahiri, Abdollah Mohammadian-Hafshejani, Hamid Salehiniya
Format: Article
Language:fas
Published: Isfahan University of Medical Sciences 2015-06-01
Series:مجله دانشکده پزشکی اصفهان
Subjects:
Online Access:http://jims.mui.ac.ir/index.php/jims/article/view/4559
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author Salman Khazaei
Ghodratollah Roshanaei
Zahra Kousehlou
Ali Zahiri
Abdollah Mohammadian-Hafshejani
Hamid Salehiniya
author_facet Salman Khazaei
Ghodratollah Roshanaei
Zahra Kousehlou
Ali Zahiri
Abdollah Mohammadian-Hafshejani
Hamid Salehiniya
author_sort Salman Khazaei
collection DOAJ
description Background: Approximately, one third of the world population is infected with tuberculosis (TB) germs and is put at risk of tuberculosis. Pulmonary tuberculosis accounts for more than 80 percent of cases, mostly in adults with positive sputum smear. The mortality and morbidity of the disease are associated with delay in diagnosis. Delay in diagnosis can be related to the patients or the health care system. Methods: In this historical cohort study, all the patients with smear-positive pulmonary tuberculosis in Hamadan province from 21 March 2006 to 20 March 2012 were studied. Data on demographic characteristics, and clinical and treatment status of patients were extracted using patient registry software entitled TB Register. To determine the relationship between variables and the bacillus load, chi-square test was used. The logistic regression model was used to examine the co-effects of both variables on bacillus load of the patients at the time of the diagnosis. Data were analyzed using Stata11 software. Findings: From 440 patients with smear-positive pulmonary tuberculosis, 51% (221 patients) were men and 49% (219 patients) were women. 57% (251 people) were living in urban and others in rural areas. The grade of sputum smear at the time of diagnosis was associated with area of residence, age group, and gender, that all were statistically significant. Delay in diagnosis among women, was approximately 0.55 of men and those in urban areas were 67% higher than in rural areas, which were both statistically significant. Conclusion: Individual factors play important role in delayed diagnosis, regarding that men are diagnosed later than the women. Screening programs in the workplace are recommended. Sensitization of private physicians would be effective in early identification of patients in urban areas.
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spelling doaj.art-32859957f1824567a40cbb5e4b6541b92023-09-02T23:32:56ZfasIsfahan University of Medical Sciencesمجله دانشکده پزشکی اصفهان1027-75951735-854X2015-06-01333325966031862Assessment of Related Factors on Delay in Diagnosis of Patients with Smear-Positive Pulmonary TuberculosisSalman Khazaei0Ghodratollah Roshanaei1Zahra Kousehlou2Ali Zahiri3Abdollah Mohammadian-Hafshejani4Hamid Salehiniya5Department of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IranAssistant Professor, Health Sciences Research Center AND Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IranDepartment of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IranDeputy for Health, Hamadan University of Medical Sciences, Hamadan, IranEpidemiologist, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan AND PhD Student, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, IranResearcher, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences AND PhD Student, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IranBackground: Approximately, one third of the world population is infected with tuberculosis (TB) germs and is put at risk of tuberculosis. Pulmonary tuberculosis accounts for more than 80 percent of cases, mostly in adults with positive sputum smear. The mortality and morbidity of the disease are associated with delay in diagnosis. Delay in diagnosis can be related to the patients or the health care system. Methods: In this historical cohort study, all the patients with smear-positive pulmonary tuberculosis in Hamadan province from 21 March 2006 to 20 March 2012 were studied. Data on demographic characteristics, and clinical and treatment status of patients were extracted using patient registry software entitled TB Register. To determine the relationship between variables and the bacillus load, chi-square test was used. The logistic regression model was used to examine the co-effects of both variables on bacillus load of the patients at the time of the diagnosis. Data were analyzed using Stata11 software. Findings: From 440 patients with smear-positive pulmonary tuberculosis, 51% (221 patients) were men and 49% (219 patients) were women. 57% (251 people) were living in urban and others in rural areas. The grade of sputum smear at the time of diagnosis was associated with area of residence, age group, and gender, that all were statistically significant. Delay in diagnosis among women, was approximately 0.55 of men and those in urban areas were 67% higher than in rural areas, which were both statistically significant. Conclusion: Individual factors play important role in delayed diagnosis, regarding that men are diagnosed later than the women. Screening programs in the workplace are recommended. Sensitization of private physicians would be effective in early identification of patients in urban areas.http://jims.mui.ac.ir/index.php/jims/article/view/4559Pulmonary tuberculosis (TB)DiagnosisTuberculosisIran
spellingShingle Salman Khazaei
Ghodratollah Roshanaei
Zahra Kousehlou
Ali Zahiri
Abdollah Mohammadian-Hafshejani
Hamid Salehiniya
Assessment of Related Factors on Delay in Diagnosis of Patients with Smear-Positive Pulmonary Tuberculosis
مجله دانشکده پزشکی اصفهان
Pulmonary tuberculosis (TB)
Diagnosis
Tuberculosis
Iran
title Assessment of Related Factors on Delay in Diagnosis of Patients with Smear-Positive Pulmonary Tuberculosis
title_full Assessment of Related Factors on Delay in Diagnosis of Patients with Smear-Positive Pulmonary Tuberculosis
title_fullStr Assessment of Related Factors on Delay in Diagnosis of Patients with Smear-Positive Pulmonary Tuberculosis
title_full_unstemmed Assessment of Related Factors on Delay in Diagnosis of Patients with Smear-Positive Pulmonary Tuberculosis
title_short Assessment of Related Factors on Delay in Diagnosis of Patients with Smear-Positive Pulmonary Tuberculosis
title_sort assessment of related factors on delay in diagnosis of patients with smear positive pulmonary tuberculosis
topic Pulmonary tuberculosis (TB)
Diagnosis
Tuberculosis
Iran
url http://jims.mui.ac.ir/index.php/jims/article/view/4559
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