ArticleBMC health services research2018
Delay in diagnosis and treatment among adult multidrug resistant tuberculosis patients in Yangon Regional Tuberculosis Center, Myanmar: a cross-sectional study.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 30 citations in OpenAlex.
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- Factors associated with delayed diagnosis of pulmonary tuberculosis in Chitwan district of Nepal.PLOS global public health · 2026Article
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- Patient costs for drug-resistant TB diagnosis and pre-treatment evaluation in North India.Public health action · 2024Article
- Novel automated AIMLAM for diagnosis ofFuture microbiology · 2024Article
- Risk factors for diagnosis and treatment delay among patients with multidrug-resistant tuberculosis in Hunan Province, China.BMC infectious diseases · 2024Article
- Healthcare seeking behavior and delays in case of Drug-Resistant Tuberculosis patients in Bangladesh: Findings from a cross-sectional survey.PLOS global public health · 2024Article
- Tuberculosis diagnostic and treatment delays among patients in Uganda.Health science reports · 2023Article
- Prognostication of treatment non-compliance among patients with multidrug-resistant tuberculosis in the course of their follow-up: a logistic regression-based machine learning algorithm.Frontiers in digital health · 2023Article
- Factors affecting the tuberculosis program coverage at the first level of care in HondurasBiomedica : revista del Instituto Nacional de Salud · 2022Article
- Development and validity of an educational folder for pulmonary tuberculosis sputum collection.Revista brasileira de enfermagem · 2022Article
- Impact of Molecular Drug Susceptibility Testing on the Time to Multidrug-resistant Tuberculosis Treatment Initiation.Journal of Korean medical science · 2020Article
- User experience and patient satisfaction with tuberculosis care in low- and middle-income countries: A systematic review.Journal of clinical tuberculosis and other mycobacterial diseases · 2020Article
- TB treatment delay associated with drug resistance and admission at Daru General Hospital in Papua New Guinea.Public health action · 2019Article
- Artificial Neural Networks for Prediction of Tuberculosis Disease.Frontiers in microbiology · 2019Article
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10 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundDelays in diagnosis and treatment initiation may allow the emergence of new cases by transmission to the community, and is one of the challenges facing programme management of drug resistance in Myanmar. This study aimed to explore delays in diagnosis and treatment initiation, and associated factors among patients with multidrug-resistant tuberculosis.
methodsA cross-sectional study was conducted at Yangon Regional Tuberculosis Centre, Myanmar. Data were collected by face-to-face interviews and treatment-card reviews of all adult patients who had registered and started treatment with the standard regimen from May to November, 2017. Delay time was categorized by using median cut-off and analyzed using SPSS version 23.0. Logistic regression analysis was performed to assess the relative impact of predictor variables on diagnosis and treatment delays.
resultsA total of 210 patients participated in this study. The median diagnosis delay was 9 days, IQR 3 (8-11) and 58.6% of the patients experienced a long diagnosis delay. Below middle school education (adjusted odds ratio [AOR] = 2.75, 95% CI = 1.22-6.21), non-permanent salaried employment (AOR = 3.03, 95% CI = 1.32-6.95), co-existing diabetes mellitus (AOR = 5.06, 95% CI = 1.97-13.01) and poor awareness (AOR = 2.99, 95% CI = 1.29-6.92) were independent predictors of long diagnosis delay. The median treatment delay was 13 days, IQR 9 (8-17) and 51% of the patients experienced long treatment delay. Age 31-50 years (AOR = 4.50, 95% CI = 1.47-13.97) and age > 50 years (AOR = 9.40, 95% CI = 2.55-34.83), history with MDR-TB patient (AOR = 3.16, 95% CI = 1.29-7.69), > 20 km away from a Regional TB Centre (AOR = 14.33, 95% CI = 1.91-107.64) and poor awareness (AOR = 4.62, 95% CI = 1.56-13.67) were independent predictors of long treatment delay.
conclusionsStrengthening comprehensive health education, enhancing treatment adherence counseling, providing more Xpert MTB/RIF machines, expanding decentralized MDR-TB treatment centers, ensuring timely sputum transportation, provision of a patient support package immediately after confirmation, and strengthening contact-tracing for all household contacts with MDR-TB patients and active tuberculosis screening were the most effective ways to shorten delays in MDR-TB diagnosis and treatment initiation.
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