Tuberculosis in Greenland - Time from first contact to diagnosis and treatment

Tuberculosis (TB) is a persistent health issue in Greenland. While rapid diagnosis is crucial to reducing transmission of the disease, remote settlements have limited access to healthcare services. We aimed to assess and compare the time intervals from first contact to diagnosis and treatment for patients with active TB in the cities and settlements of Greenland. A total of 153 cases were included and divided according to place of residence and whether the diagnosis was based on symptomatic presentation or contact tracing. The median time from first contact to diagnosis was 19 days for the total population. The symptomatic settlement population waited longer (median = 88.5 days) than the symptomatic city population (median = 19 days) (p = 0.018). The system interval was longer for the symptomatic settlement population than for the symptomatic city population with a median of 49.5 days vs. 3 days for chest imaging (p < 0.001) and 66.5 days vs. 10 days for expectorate sample (p = 0.008). The diagnostic, system, and total intervals were significantly longer for symptomatic patients in settlements than in cities. This may explain a higher TB incidence in the settlements and calls for the development of better diagnostic pathways.