The effect of diagnostic delays on the drop-out rate and the total delay to diagnosis of tuberculosis.

BACKGROUND: Numerous patient and healthcare system-related delays contribute to the overall delay experienced by patients from onset of TB symptoms to diagnosis and treatment. Such delays are critical as infected individuals remain untreated in the community, providing more opportunities for transmi...

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Main Authors: Stephen J Millen, Pieter W Uys, John Hargrove, Paul D van Helden, Brian G Williams
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2008-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC2276686?pdf=render
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author Stephen J Millen
Pieter W Uys
John Hargrove
Paul D van Helden
Brian G Williams
author_facet Stephen J Millen
Pieter W Uys
John Hargrove
Paul D van Helden
Brian G Williams
author_sort Stephen J Millen
collection DOAJ
description BACKGROUND: Numerous patient and healthcare system-related delays contribute to the overall delay experienced by patients from onset of TB symptoms to diagnosis and treatment. Such delays are critical as infected individuals remain untreated in the community, providing more opportunities for transmission of the disease and adversely affecting the epidemic. METHODOLOGY/PRINCIPAL FINDINGS: We present an analysis of the factors that contribute to the overall delay in TB diagnosis and treatment, in a resource-poor setting. Impact on the distribution of diagnostic delay times was assessed for various factors, the sensitivity of the diagnostic method being found to be the most significant. A linear relationship was found between the sensitivity of the test and the predicted mean delay time, with an increase in test sensitivity resulting in a reduced mean delay time and a reduction in the drop-out rate. CONCLUSIONS/SIGNIFICANCE: The results show that in a developing country a number of delay factors, particularly the low sensitivity of the initial sputum smear microscopy test, potentially increase total diagnostic delay times experienced by TB patients significantly. The results reinforce the urgent need for novel diagnostic methods, both for smear positive and negative TB, that are highly sensitive, accessible and point of care, in order to reduce mean delay times.
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spelling doaj.art-45d50b239e294b0d80e88e2a34a3ccce2022-12-21T19:42:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032008-01-0134e193310.1371/journal.pone.0001933The effect of diagnostic delays on the drop-out rate and the total delay to diagnosis of tuberculosis.Stephen J MillenPieter W UysJohn HargrovePaul D van HeldenBrian G WilliamsBACKGROUND: Numerous patient and healthcare system-related delays contribute to the overall delay experienced by patients from onset of TB symptoms to diagnosis and treatment. Such delays are critical as infected individuals remain untreated in the community, providing more opportunities for transmission of the disease and adversely affecting the epidemic. METHODOLOGY/PRINCIPAL FINDINGS: We present an analysis of the factors that contribute to the overall delay in TB diagnosis and treatment, in a resource-poor setting. Impact on the distribution of diagnostic delay times was assessed for various factors, the sensitivity of the diagnostic method being found to be the most significant. A linear relationship was found between the sensitivity of the test and the predicted mean delay time, with an increase in test sensitivity resulting in a reduced mean delay time and a reduction in the drop-out rate. CONCLUSIONS/SIGNIFICANCE: The results show that in a developing country a number of delay factors, particularly the low sensitivity of the initial sputum smear microscopy test, potentially increase total diagnostic delay times experienced by TB patients significantly. The results reinforce the urgent need for novel diagnostic methods, both for smear positive and negative TB, that are highly sensitive, accessible and point of care, in order to reduce mean delay times.http://europepmc.org/articles/PMC2276686?pdf=render
spellingShingle Stephen J Millen
Pieter W Uys
John Hargrove
Paul D van Helden
Brian G Williams
The effect of diagnostic delays on the drop-out rate and the total delay to diagnosis of tuberculosis.
PLoS ONE
title The effect of diagnostic delays on the drop-out rate and the total delay to diagnosis of tuberculosis.
title_full The effect of diagnostic delays on the drop-out rate and the total delay to diagnosis of tuberculosis.
title_fullStr The effect of diagnostic delays on the drop-out rate and the total delay to diagnosis of tuberculosis.
title_full_unstemmed The effect of diagnostic delays on the drop-out rate and the total delay to diagnosis of tuberculosis.
title_short The effect of diagnostic delays on the drop-out rate and the total delay to diagnosis of tuberculosis.
title_sort effect of diagnostic delays on the drop out rate and the total delay to diagnosis of tuberculosis
url http://europepmc.org/articles/PMC2276686?pdf=render
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