Association between diagnostic delay and prognosis of pulmonary tuberculosis in Shandong, China: a retrospective study
Abstract Background Tuberculosis (TB) is one of the main infectious diseases that seriously threatens global health, while diagnostic delay (DD) and treatment dramatically threaten TB control. Methods Between 2005 and 2017 in Shandong, China, we enrolled pulmonary tuberculosis (PTB) patients with DD...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-022-02101-z |
| _version_ | 1811320977445879808 |
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| author | Xue-han Zhu Ning-ning Tao Qian-yun Zhang Wan-mei Song Qi-qi An Si-qi Liu Yi-fan Li Fei Long Huai-chen Li |
| author_facet | Xue-han Zhu Ning-ning Tao Qian-yun Zhang Wan-mei Song Qi-qi An Si-qi Liu Yi-fan Li Fei Long Huai-chen Li |
| author_sort | Xue-han Zhu |
| collection | DOAJ |
| description | Abstract Background Tuberculosis (TB) is one of the main infectious diseases that seriously threatens global health, while diagnostic delay (DD) and treatment dramatically threaten TB control. Methods Between 2005 and 2017 in Shandong, China, we enrolled pulmonary tuberculosis (PTB) patients with DD. DD trends were evaluated by Joinpoint regression, and associations between PTB patient characteristics and DD were estimated by univariate and multivariate logistic regression. The influence of DD duration on prognosis and sputum smear results were assessed by Spearman correlation coefficients. Results We identified 208,822 PTB cases with a median DD of 33 days (interquartile range (IQR) 18–63). The trend of PTB with DD declined significantly between 2009 and 2017 (annual percent change (APC): − 4.0%, P = 0.047, 2009–2013; APC: − 6.6%, P = 0.001, 2013–2017). Patients aged > 45 years old (adjusted odds ratio (aOR): 1.223, 95% confidence interval (CI) 1.189–1.257, 46–65 years; aOR: 1.306, 95% CI 1.267–1.346, > 65 years), farmers (aOR: 1.520, 95% CI 1.447–1.596), and those with a previous treatment history (aOR: 1.759, 95% CI 1.699–1.821) were prone to developing long DD (> 30 days, P < 0.05). An unfavorable outcome was negatively associated with a short DD (OR: 0.876, 95% CI 0.843–0.910, P < 0.001). Sputum smear positive rate and unfavorable outcomes were positively correlated with DD duration (Spearman correlation coefficients (rs) = 1, P < 0.001). Conclusions The DD situation remains serious; more efficient and comprehensive strategies are urgently required to minimize DD, especially for high-risk patients. |
| first_indexed | 2024-04-13T13:08:55Z |
| format | Article |
| id | doaj.art-de52d59928664e0d8290e21bc3ae2672 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-04-13T13:08:55Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-de52d59928664e0d8290e21bc3ae26722022-12-22T02:45:40ZengBMCBMC Pulmonary Medicine1471-24662022-08-0122111110.1186/s12890-022-02101-zAssociation between diagnostic delay and prognosis of pulmonary tuberculosis in Shandong, China: a retrospective studyXue-han Zhu0Ning-ning Tao1Qian-yun Zhang2Wan-mei Song3Qi-qi An4Si-qi Liu5Yi-fan Li6Fei Long7Huai-chen Li8Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong UniversityDepartment of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong UniversityDepartment of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong UniversityDepartment of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong UniversityDepartment of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Pulmonary and Critical Care Medicine, The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences)Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityAbstract Background Tuberculosis (TB) is one of the main infectious diseases that seriously threatens global health, while diagnostic delay (DD) and treatment dramatically threaten TB control. Methods Between 2005 and 2017 in Shandong, China, we enrolled pulmonary tuberculosis (PTB) patients with DD. DD trends were evaluated by Joinpoint regression, and associations between PTB patient characteristics and DD were estimated by univariate and multivariate logistic regression. The influence of DD duration on prognosis and sputum smear results were assessed by Spearman correlation coefficients. Results We identified 208,822 PTB cases with a median DD of 33 days (interquartile range (IQR) 18–63). The trend of PTB with DD declined significantly between 2009 and 2017 (annual percent change (APC): − 4.0%, P = 0.047, 2009–2013; APC: − 6.6%, P = 0.001, 2013–2017). Patients aged > 45 years old (adjusted odds ratio (aOR): 1.223, 95% confidence interval (CI) 1.189–1.257, 46–65 years; aOR: 1.306, 95% CI 1.267–1.346, > 65 years), farmers (aOR: 1.520, 95% CI 1.447–1.596), and those with a previous treatment history (aOR: 1.759, 95% CI 1.699–1.821) were prone to developing long DD (> 30 days, P < 0.05). An unfavorable outcome was negatively associated with a short DD (OR: 0.876, 95% CI 0.843–0.910, P < 0.001). Sputum smear positive rate and unfavorable outcomes were positively correlated with DD duration (Spearman correlation coefficients (rs) = 1, P < 0.001). Conclusions The DD situation remains serious; more efficient and comprehensive strategies are urgently required to minimize DD, especially for high-risk patients.https://doi.org/10.1186/s12890-022-02101-zDiagnostic delayPulmonary tuberculosisTrendPoor prognosis |
| spellingShingle | Xue-han Zhu Ning-ning Tao Qian-yun Zhang Wan-mei Song Qi-qi An Si-qi Liu Yi-fan Li Fei Long Huai-chen Li Association between diagnostic delay and prognosis of pulmonary tuberculosis in Shandong, China: a retrospective study BMC Pulmonary Medicine Diagnostic delay Pulmonary tuberculosis Trend Poor prognosis |
| title | Association between diagnostic delay and prognosis of pulmonary tuberculosis in Shandong, China: a retrospective study |
| title_full | Association between diagnostic delay and prognosis of pulmonary tuberculosis in Shandong, China: a retrospective study |
| title_fullStr | Association between diagnostic delay and prognosis of pulmonary tuberculosis in Shandong, China: a retrospective study |
| title_full_unstemmed | Association between diagnostic delay and prognosis of pulmonary tuberculosis in Shandong, China: a retrospective study |
| title_short | Association between diagnostic delay and prognosis of pulmonary tuberculosis in Shandong, China: a retrospective study |
| title_sort | association between diagnostic delay and prognosis of pulmonary tuberculosis in shandong china a retrospective study |
| topic | Diagnostic delay Pulmonary tuberculosis Trend Poor prognosis |
| url | https://doi.org/10.1186/s12890-022-02101-z |
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