ArticleBMC infectious diseases2016
Patients' and health system's delays in the diagnosis and treatment of new pulmonary tuberculosis patients in West Gojjam Zone, Northwest Ethiopia: a cross-sectional study.
Article in BMC infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Systematic review of barriers to and enablers of tuberculosis diagnosis, notification, and intervention for designing customised intervention package to minimise 'missing millions' in tribal communities of India.Journal of global health · 2025Pooled it
- Duration and determinants of delayed tuberculosis diagnosis and treatment in high-burden countries: a mixed-methods systematic review and meta-analysis.Respiratory research · 2021Pooled it
- Patient delay in the diagnosis of tuberculosis in Ethiopia: a systematic review and meta-analysis.BMC infectious diseases · 2020Pooled it
- Trial
- Delayed diagnosis of patients with rifampicin-resistant tuberculosis and its associated factors in a high tuberculosis endemic area Guizhou, China.BMC infectious diseases · 2026Article
- Diagnostic and treatment delays and associated factors among RR-TB patients under molecular drug susceptibility testing: a retrospective study in Guizhou Province, China.BMC infectious diseases · 2026Article
- Clinically diagnosed tuberculosis and mortality in high burden settings: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Analysis of diagnosis delay among migrant pulmonary tuberculosis patients in Guangzhou from 2014 to 2022.Frontiers in public health · 2025Article
- Family dynamics and diagnostic delay among pulmonary tuberculosis patients in Ile-Ife, South-Western Nigeria.SAGE open medicine · 2025Article
- Patient and health system delays in the diagnosis and treatment of tuberculosis in Gandaki, Nepal.PLOS global public health · 2025Article
- Determinants of an unfavorable treatment outcome among tuberculosis patients in the Jimma Zone, Southwest Ethiopia.Scientific reports · 2024Article
- Tuberculosis treatment delay and associated factors among pulmonary tuberculosis patients at public health facilities in Dale District and Yirgalem Town administration, Sidama Region, South Ethiopia.BMC infectious diseases · 2024Article
- Article
- Delay in seeking treatment and associated factors among pulmonary tuberculosis patients attending public health facilities in the Metekel zone, Benishangul Gumuz region, Western Ethiopia.Frontiers in public health · 2024Article
- The magnitude of health care seeking delay and associated factors for tuberculosis suggestive symptoms in Sidama Region Ethiopia: Community-based cross-sectional study.Public health in practice (Oxford, England) · 2023Article
- Time-trend analysis of tuberculosis diagnosis in Shenzhen, China between 2011 and 2020.Frontiers in public health · 2023Article
- Magnitude and determinants of delay in diagnosis of tuberculosis patients in Ethiopia: a systematic review and meta-analysis: 2020.Archives of public health = Archives belges de sante publique · 2022Article
- Impact of Protracted Displacement on Delay in the Diagnosis Associated with Treatment Outcomes: A Cross-Sectional Study in Internally Displaced Tuberculosis Patients of Pakistan.International journal of environmental research and public health · 2021Article
- Patient and health system delay among TB patients in Ethiopia: Nationwide mixed method cross-sectional study.BMC public health · 2020Article
- Through service providers' eyes: health systems factors affecting implementation of tuberculosis control in Enugu State, South-Eastern Nigeria.BMC infectious diseases · 2020Article
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTuberculosis (TB) is a major public health concern in the developing world. Early diagnosis and prompt initiation of treatment is essential for effective TB control. The aim of this study was to determine the length and analyze associated factors of patients' and health system's delays in the diagnosis and treatment of new pulmonary TB (PTB) patients.
methodsA cross-sectional study was conducted in 30 randomly selected public health facilities in West Gojjam Zone, Amhara Region, Ethiopia. Newly diagnosed PTB patients who were ≥15 years of age were consecutively enrolled in the study. Patients' delay (the time period from onset of TB symptoms to first presentation to a formal health provider) and health system's delay (the time period from first presentation to a formal health provider to first start of TB treatment) were measured. Median patients' and health system's delays were calculated. Mixed effect logistic regression was used to analyze predictors of patients' and health system's delays.
resultsSeven hundred six patients were enrolled in the study. The median patients' delay was 18 days (interquartile range [IQR]: 8-34 days) and the median health system's delay was 22 days (IQR: 4-88 days). Poor knowledge of TB (adjusted odds ratio [AOR], 2.33; 95 % confidence interval [CI], 1.34-4.05), first visit to non-formal health provider (AOR, 47.56; 95 % CI, 26.31-85.99), self-treatment (AOR, 10.11; 95 % CI, 4.53-22.56) and patients' age (≥45 years) (AOR, 2.99; 95 % CI, 1.14-7.81) were independent predictors of patients' delay. Smear-negative TB (AOR, 1.88; 95 % CI, 1.32-2.68) and first visit to public health centers (AOR, 2.22; 95 % CI, 1.52-3.25) and health posts (AOR, 5.86; 95 % CI, 1.40-24.39) were found to be independent predictors of health system's delay.
conclusionsThe health system's delay in this study was long and contributed more than 50 % of the total delay. Better TB diagnostic tools to complement sputum smear microscopy are needed to early diagnose PTB cases at peripheral health facilities. In addition, due emphasis should be given to increase public awareness about symptoms and consequences of TB disease.
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