Evidence map›Paper›PMID 24670558›Full record

SynthesisThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2014

Delays in diagnosis and treatment of pulmonary tuberculosis in India: a systematic review.

Chandrashekhar T Sreeramareddy, Zhi Zhen Qin, Srinath Satyanarayana, Ramnath Subbaraman, Madhukar Pai

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 190 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
190citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

190 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  10. Quality of tuberculosis care in India: a systematic review.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2015
    Pooled it
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  13. Decentralised patient-centred TB diagnostics: key considerations for India.The Lancet regional health. Southeast Asia · 2026
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130 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Chandrashekhar T Sreeramareddy *Department of Population Medicine, Faculty of Medicine and Health Science, University Tunku Abdul Rahman, Bandar Sungai Long, 43000, Selangor, Malaysia.
Zhi Zhen Qin *McGill University & McGill International TB Centre, Dept of Epidemiology & Biostatistics, 1020 Pine Ave West, Montreal, QC H3A 1A2, Canada.
Srinath SatyanarayanaMcGill University & McGill International TB Centre, Dept of Epidemiology & Biostatistics, 1020 Pine Ave West, Montreal, QC H3A 1A2, Canada.
Ramnath SubbaramanDivision of Infectious Diseases, Brigham and Women's Hospital, Boston, MA 02115, USA.
Madhukar PaiMcGill University & McGill International TB Centre, Dept of Epidemiology & Biostatistics, 1020 Pine Ave West, Montreal, QC H3A 1A2, Canada.

Funding

PROGRAM FOR AIDS CLINICAL RESEARCH TRAINING (PACRT)T32AI007433 · NIAID · MASSACHUSETTS GENERAL HOSPITAL · PI MARK J SIEDNER · 1992 to 2026
$11.4M
NIAID NIH HHS T32 AI 007433NIAID NIH HHS T32 AI007433
6 · The paper itself

Abstract

objectiveTo systematically review Indian literature on delays in tuberculosis (TB) diagnosis and treatment.

methodsWe searched multiple sources for studies on delays in patients with pulmonary TB and those with chest symptoms. Studies were included if numeric data on any delay were reported. Patient delay was defined as the interval between onset of symptoms and the patient's first contact with a health care provider. Diagnostic delay was defined as the interval between the first consultation with a health care provider and diagnosis. Treatment delay was defined as the interval between diagnosis and initiation of anti-tuberculosis treatment. Total delay was defined as time interval from the onset of symptoms until treatment initiation.

resultsAmong 541 potential citations identified, 23 studies met the inclusion criteria. Included studies used a variety of definitions for onset of symptoms and delays. Median estimates of patient, diagnostic and treatment delay were respectively 18.4 (IQR 14.3-27.0), 31.0 (IQR 24.5-35.4) and 2.5 days (IQR 1.9-3.6) for patients with TB and those with chest symptoms combined. The median total delay was 55.3 days (IQR 46.5-61.5). About 48% of all patients first consulted private providers; an average of 2.7 health care providers were consulted before diagnosis. Number and type of provider first consulted were the most important risk factors for delay.

conclusionsThese findings underscore the need to develop novel strategies for reducing patient and diagnostic delays and engaging first-contact health care providers.

Indexed as

Bacteriological TechniquesDelayed DiagnosisTime-to-TreatmentAntitubercular AgentsDelivery of Health CareHumansIndiaPatient Acceptance of Health CarePredictive Value of TestsRisk FactorsTime FactorsTreatment OutcomeTuberculosis, PulmonaryAntitubercular Agents

Identifiers

PMID24670558
PMCPMC4070850

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.