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Factors associated with diagnostic delay in recurrent TB
Zhongyao Xie1, Tingwei Wang2, Hongguang Chen3
1Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China.
BMC Public Health
|August 11, 2020
Summary
Recurrent tuberculosis (TB) cases experience significantly longer diagnostic delays than new TB cases. Interventions should target immigrants and improve public health services to reduce this delay.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Recurrent tuberculosis (TB) significantly contributes to the overall TB burden.
- Understanding diagnostic delays in recurrent TB is crucial for effective control strategies.
Purpose of the Study:
- To explore the duration of diagnostic delay in patients with recurrent TB in China.
- To identify risk factors associated with diagnostic delay in recurrent TB cases.
Main Methods:
- A cohort of 13,334 new and recurrent TB patients in Yulin, China, was analyzed.
- Kaplan-Meier survival curves estimated median delay times.
- Mixed-effects survival models identified correlates of diagnostic delay.
Main Results:
- Recurrent TB accounted for 6.5% of cases, with a median delay of 73 days (vs. 35 days for new TB).
- Recurrent TB patients faced a higher risk of diagnostic delay (HR, 0.5; 95% CI, 0.5-0.6).
- Factors like immigrant status, notification by recommendation, and diagnosis at a TB dispensary were linked to longer delays in recurrent TB.
Conclusions:
- A substantial proportion of TB cases are due to recurrence, characterized by prolonged diagnostic delays.
- Targeted interventions for immigrants, enhanced primary healthcare services, and updated TB management models are recommended to mitigate delays.
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