Factors Associated with Delay in Diagnosis of Tuberculosis in Ardabil Province

Transmission of tuberculosis occurs usually by aerosols, Produced with patient’s cough. So early diagnosis and proper treatment of patients as a disease reservoir, has a special importance. It seems that every TB patient can infect 10 to 15 people annually during contagion period. For these reasons this study has been planned to evaluate delay time in TB diagnosis.

This is a descriptive analytical cross sectional study performed among all of the TB patients diagnosed in 18 months of study in Ardabil province(from April 2010 to September 2011). Data for questionnaire was collected with interview and analysis, was done with SPSS software version 16. ANOVA, t test, chi-squared statistical tests were used for hypothesis assay.

126 patients whom diagnosis confirmed by scientific tuberculosis committee of province were entered the study.68 patients (54.4%) were smear positive. Mean, standard deviation and median for these patients were 43.8,64.3,20 days respectively. The same numbers for smear negative patients were 43.4, 70.7, and 21 days. There was not any significant statistical difference between smear negative and smear positive patients in patients delay. (P=0.9) the same numbers for diagnosis delay for smear positive versus smear negative patients were 15.6, 22.1,5 days and 46.2,49.2,24 days respectively. This difference was significant statistically (P=000).With definition of patient delay as medical request after 14 days symptomatic illness, it was revealed that only 38.3% of smear positive patients were returned to any treatment centers in fewer than 14 days of symptoms onset. Despite this, proper diagnosis was made in 70.1% of smear positive patients in less than 15 days. Marital state, less than high school education, residence in villages were associated with patients delay. Symptomatic productive cough were associated with reduced latency of diagnosis.

Greater patients delay for treatment request was associated with decrease in diagnostic delay. Delay in diagnosis of smear negative pulmonary tuberculosis and extrapulmonary tuberculosis was more than smear positive pulmonary tuberculosis. The most delays in reaching the correct diagnosis are related to patient. Increasing public knowledge about signs and symptoms of tuberculosis and disease spread ways, along with increasing access to health care services can be useful strategies.