Differing influence on delays in the case-finding process for tuberculosis between general physicians and specialists...

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Healthcare Access

Background:

• Tuberculosis (TB) case-finding is crucial for disease control.
• Delays in diagnosis prolong infectious periods and worsen patient outcomes.
• Understanding factors influencing diagnostic delays is essential for improving public health strategies.

Purpose of the Study:

• To compare the impact of initial medical facility type on tuberculosis case-finding delays.
• To analyze patient and doctor delays based on whether patients first visited general physicians or other facilities.

Main Methods:

• Retrospective study of 107 adult patients with confirmed pulmonary tuberculosis in Ulaanbaatar, Mongolia.
• Data collected via patient interviews and medical record reviews.
• Analysis of demographic, socioeconomic factors, and diagnostic delays.

Main Results:

• Patients initially consulting general physicians experienced shorter patient delays but longer doctor delays compared to those visiting other facilities first.
• The reduction in patient delay among those seeing general physicians first outweighed the increase in doctor delay, resulting in shorter total delays.
• This beneficial effect on total delay persisted after adjusting for patient age, sex, residence, income, and TB family history.

Conclusions:

• General physicians play a vital role in expediting the tuberculosis passive case-finding process in Mongolia.
• Initiating care with general physicians can optimize diagnostic timelines and potentially improve TB control efforts.
• Healthcare system strategies should leverage the role of primary care physicians in early TB detection.