Causes of Delay in Diagnosis of Smear-Positive Pulmonary Tuberculosis Patients Referred to the Tuberculosis Center of Zahedan

Tuberculosis is now the major cause of mortality in the world. This study has tried to identify the factors affecting the diagnosis of this disease by determining the relationship between delay in diagnosis and factors associated with patient and health system. This research was a cross-sectional study conducted on smear positive pulmonary tuberculosis patients referred to the tuberculosis center in the first half of 2008. Required information was completed through patient records and patient interviews. A total 98 patients were studied including 42 males and 56 females. Average age of patients was 51.6±19.57. Average delay in diagnosis was 2.8±1.78 months. The average delay of patients and health system was respectively 2.6±1.76 months and 6±4.27days. Data analysis showed that there is no relationship between the delay in diagnosis and individual variables such as age, gender, occupation, etc., and examination of sputum smears at the first visit. However, there is a significant relationship between patient delay with different factors such as education (p=0.03), marital status (p=0.03), existence of hospital or medical centers in the residence (p=0.02), distance to the medical center (p=0.02) and between health system delay and residence in the city (p=0.01), distance to this medical center (p=0.03) and obtaining chest X-ray (CXR) in the first visit (p=0.003). The results showed that with the increase of literacy, the establishment of new hospitals and health centers in remote areas and suburbs as well as chest X-ray in the first visit, the amount of delay in diagnosis can be reduced.