Pulmonary tuberculosis: Diagnostic delay in Tunisia

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Tuberculosis (TB) remains a significant global health challenge, especially in high-prevalence regions.
• Early diagnosis and effective treatment are critical for controlling TB transmission and improving patient outcomes.

Purpose of the Study:

• To evaluate diagnostic delays in tuberculosis patients.
• To identify risk factors contributing to patient and healthcare system delays in TB diagnosis and treatment initiation.

Main Methods:

• A survey was conducted in Tunisian health facilities from March to October 2014.
• Included 352 adult patients with pulmonary TB (PTB) initiated on anti-TB treatment.
• Analyzed delays from symptom onset to treatment initiation, categorizing them into patient, healthcare system, and overall delays.

Main Results:

• The median time from symptom onset to treatment initiation was 52.56 days.
• Patient delays were longer in men, those with alcohol dependence, and individuals aware of their illness.
• Healthcare system delays were associated with older age, female patients, private physician consultations, and outpatients.

Conclusions:

• Significant delays in TB diagnosis and treatment were observed.
• Improved public education on TB symptoms and enhanced healthcare professional training are recommended to reduce diagnostic delays and ensure timely treatment.