The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data
OBJECTIVES Early diagnosis is essential for effective tuberculosis (TB) control programs. Therefore, this study examined the risk of delays in TB diagnosis and associated factors in Ardabil Province in northwest Iran from 2005 to 2016. METHODS This longitudinal retrospective cohort study was conduct...
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| Format: | Article |
| Language: | English |
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Korean Society of Epidemiology
2022-07-01
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| Series: | Epidemiology and Health |
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| Online Access: | http://www.e-epih.org/upload/pdf/epih-44-e2022060.pdf |
| _version_ | 1827246914429517824 |
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| author | Reza Ebrahimoghli Hassan Ghobadi Davoud Adham Parviz Jangi Abbas Abbasi-Ghahramanloo Eslam Moradi-Asl |
| author_facet | Reza Ebrahimoghli Hassan Ghobadi Davoud Adham Parviz Jangi Abbas Abbasi-Ghahramanloo Eslam Moradi-Asl |
| author_sort | Reza Ebrahimoghli |
| collection | DOAJ |
| description | OBJECTIVES Early diagnosis is essential for effective tuberculosis (TB) control programs. Therefore, this study examined the risk of delays in TB diagnosis and associated factors in Ardabil Province in northwest Iran from 2005 to 2016. METHODS This longitudinal retrospective cohort study was conducted using data obtained from the Iranian National Tuberculosis Control Program at the provincial level between 2005 and 2016. The total delay in diagnosis was defined as the time interval (days) between the onset of symptoms and TB diagnosis. Survival analysis was conducted to analyze the delay in diagnosis. Associated factors were identified using a Cox proportional hazards model. RESULTS A total of 1,367 new TB cases were identified. The 12-year median diagnostic delay was 45 days (interquartile range [IQR], 30-87). The annual median diagnostic delay decreased from 68 days (IQR, 33-131) in 2005 to 31 days (IQR, 30-62) in 2016. The probability of a delay in TB diagnosis decreased by 5.0% each year (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.04 to 1.07). Residence in a non-capital county (HR, 0.83; 95% CI, 0.74 to 0.92) and referral from the private health system (HR, 0.74%; 95% CI, 0.65 to 0.84) were significantly associated with an increased risk of delay in TB diagnosis over the 12-year study period. CONCLUSIONS The median delay decreased during the study period. We identified factors associated with a longer delay in TB diagnosis. These findings may be useful for further TB control plans and policies in Iran. |
| first_indexed | 2024-03-12T20:52:56Z |
| format | Article |
| id | doaj.art-33e03417547e4c308c66d41ff9e2f9aa |
| institution | Directory Open Access Journal |
| issn | 2092-7193 |
| language | English |
| last_indexed | 2025-03-21T23:07:32Z |
| publishDate | 2022-07-01 |
| publisher | Korean Society of Epidemiology |
| record_format | Article |
| series | Epidemiology and Health |
| spelling | doaj.art-33e03417547e4c308c66d41ff9e2f9aa2024-05-22T05:15:04ZengKorean Society of EpidemiologyEpidemiology and Health2092-71932022-07-014410.4178/epih.e20220601308The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance dataReza Ebrahimoghli0Hassan Ghobadi1Davoud Adham2Parviz Jangi3Abbas Abbasi-Ghahramanloo4Eslam Moradi-Asl5 Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran Division of Pulmonary, Department of Internal Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, IranOBJECTIVES Early diagnosis is essential for effective tuberculosis (TB) control programs. Therefore, this study examined the risk of delays in TB diagnosis and associated factors in Ardabil Province in northwest Iran from 2005 to 2016. METHODS This longitudinal retrospective cohort study was conducted using data obtained from the Iranian National Tuberculosis Control Program at the provincial level between 2005 and 2016. The total delay in diagnosis was defined as the time interval (days) between the onset of symptoms and TB diagnosis. Survival analysis was conducted to analyze the delay in diagnosis. Associated factors were identified using a Cox proportional hazards model. RESULTS A total of 1,367 new TB cases were identified. The 12-year median diagnostic delay was 45 days (interquartile range [IQR], 30-87). The annual median diagnostic delay decreased from 68 days (IQR, 33-131) in 2005 to 31 days (IQR, 30-62) in 2016. The probability of a delay in TB diagnosis decreased by 5.0% each year (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.04 to 1.07). Residence in a non-capital county (HR, 0.83; 95% CI, 0.74 to 0.92) and referral from the private health system (HR, 0.74%; 95% CI, 0.65 to 0.84) were significantly associated with an increased risk of delay in TB diagnosis over the 12-year study period. CONCLUSIONS The median delay decreased during the study period. We identified factors associated with a longer delay in TB diagnosis. These findings may be useful for further TB control plans and policies in Iran.http://www.e-epih.org/upload/pdf/epih-44-e2022060.pdftuberculosisdelayed diagnosissurvival analysisiran |
| spellingShingle | Reza Ebrahimoghli Hassan Ghobadi Davoud Adham Parviz Jangi Abbas Abbasi-Ghahramanloo Eslam Moradi-Asl The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data Epidemiology and Health tuberculosis delayed diagnosis survival analysis iran |
| title | The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data |
| title_full | The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data |
| title_fullStr | The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data |
| title_full_unstemmed | The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data |
| title_short | The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data |
| title_sort | probability of diagnostic delays for tuberculosis and its associated risk factors in northwest iran from 2005 to 2016 a survival analysis using tuberculosis surveillance data |
| topic | tuberculosis delayed diagnosis survival analysis iran |
| url | http://www.e-epih.org/upload/pdf/epih-44-e2022060.pdf |
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