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Delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: systematic review and meta-analysis

BACKGROUND: Assessment of delays in seeking care and diagnosis of tuberculosis is essential to evaluate effectiveness of tuberculosis control programs, and identify programmatic impediments. Thus, this review of studies aimed to examine the extent of patient, health system, and total delays in diagn...

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Autores principales: Getnet, Fentabil, Demissie, Meaza, Assefa, Nega, Mengistie, Bizatu, Worku, Alemayehu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729407/
https://www.ncbi.nlm.nih.gov/pubmed/29237451
http://dx.doi.org/10.1186/s12890-017-0551-y
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author Getnet, Fentabil
Demissie, Meaza
Assefa, Nega
Mengistie, Bizatu
Worku, Alemayehu
author_facet Getnet, Fentabil
Demissie, Meaza
Assefa, Nega
Mengistie, Bizatu
Worku, Alemayehu
author_sort Getnet, Fentabil
collection PubMed
description BACKGROUND: Assessment of delays in seeking care and diagnosis of tuberculosis is essential to evaluate effectiveness of tuberculosis control programs, and identify programmatic impediments. Thus, this review of studies aimed to examine the extent of patient, health system, and total delays in diagnosis of pulmonary tuberculosis in low- and middle- income countries. METHODS: It was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Electronic databases were searched to retrieve studies published from 2007 to 2015 including Pubmed central, Springer link, Hinari and Google scholar. Searching terms were pulmonary tuberculosis, health care seeking, health care seeking behavior, patient delay, diagnostic delay, health system delay, provider delay, and doctor delay. Retrieved studies were systematically reviewed and summarized using Comprehensive Meta-analysis software. RESULTS: Forty studies involving 18,975 patients qualified for systematic review, and 14 of them qualified for meta-analysis. The median diagnostic delay ranged from 30 to 366.5 days [IQR = 44–77.8], with a 4–199 days [IQR = 15–50] and 2–128.5 days [IQR = 12–34] due to patient and health system delays, respectively. The meta-analysis showed 42% of pulmonary tuberculosis patients delayed seeking care by a month or more; uneducated patients [pooled OR = 1.5, 95%CI = 1.1–1.9] and those who sought initial care from informal providers [pooled OR = 3, 95%CI = 2.3–3.9] had higher odds of patient delay. CONCLUSION: Delay in diagnosis is still a major challenge of tuberculosis control and prevention programs in low- and middle- income settings. Efforts to develop new strategies for better case-finding using the existing systems and improving patients’ care seeking behavior need to be intensified.
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spelling pubmed-57294072017-12-18 Delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: systematic review and meta-analysis Getnet, Fentabil Demissie, Meaza Assefa, Nega Mengistie, Bizatu Worku, Alemayehu BMC Pulm Med Research Article BACKGROUND: Assessment of delays in seeking care and diagnosis of tuberculosis is essential to evaluate effectiveness of tuberculosis control programs, and identify programmatic impediments. Thus, this review of studies aimed to examine the extent of patient, health system, and total delays in diagnosis of pulmonary tuberculosis in low- and middle- income countries. METHODS: It was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Electronic databases were searched to retrieve studies published from 2007 to 2015 including Pubmed central, Springer link, Hinari and Google scholar. Searching terms were pulmonary tuberculosis, health care seeking, health care seeking behavior, patient delay, diagnostic delay, health system delay, provider delay, and doctor delay. Retrieved studies were systematically reviewed and summarized using Comprehensive Meta-analysis software. RESULTS: Forty studies involving 18,975 patients qualified for systematic review, and 14 of them qualified for meta-analysis. The median diagnostic delay ranged from 30 to 366.5 days [IQR = 44–77.8], with a 4–199 days [IQR = 15–50] and 2–128.5 days [IQR = 12–34] due to patient and health system delays, respectively. The meta-analysis showed 42% of pulmonary tuberculosis patients delayed seeking care by a month or more; uneducated patients [pooled OR = 1.5, 95%CI = 1.1–1.9] and those who sought initial care from informal providers [pooled OR = 3, 95%CI = 2.3–3.9] had higher odds of patient delay. CONCLUSION: Delay in diagnosis is still a major challenge of tuberculosis control and prevention programs in low- and middle- income settings. Efforts to develop new strategies for better case-finding using the existing systems and improving patients’ care seeking behavior need to be intensified. BioMed Central 2017-12-13 /pmc/articles/PMC5729407/ /pubmed/29237451 http://dx.doi.org/10.1186/s12890-017-0551-y Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Getnet, Fentabil
Demissie, Meaza
Assefa, Nega
Mengistie, Bizatu
Worku, Alemayehu
Delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: systematic review and meta-analysis
title Delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: systematic review and meta-analysis
title_full Delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: systematic review and meta-analysis
title_fullStr Delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: systematic review and meta-analysis
title_full_unstemmed Delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: systematic review and meta-analysis
title_short Delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: systematic review and meta-analysis
title_sort delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729407/
https://www.ncbi.nlm.nih.gov/pubmed/29237451
http://dx.doi.org/10.1186/s12890-017-0551-y
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