WWW. M ED S CI M ONIT . COM Clinical Research © Med Sci Monit, 2004; 10(2): CR62-67 PMID: 14737045 CR62 Factors affecting delays in diagnosis and treatment of pulmonary tuberculosis in a tertiary care hospital in Istanbul, Turkey Döndü Güneylioglu bdefg, Adnan Yilmaz abcdefg, Sevinc ¸ Bilgin bdf, Ümmühan Bayram bf, Esen Akkaya ace Department of Pulmonology, SSK Süreyyapas ¸ a Center for Chest Diseases and Thoracic Surgery, Istanbul-Turkey Source of support: none. Summary Background: To investigate delays in the diagnosis and treatment of inpatients with smear-positive pul- monary tuberculosis and to identify factors affecting these delays. Materials/Methods: 204 hospitalized patients with smear-positive pulmonary tuberculosis were identified. The clinical files of the patients were analyzed and questionnaires were created. Results: Mean application interval was 31.4 days, mean referral interval was 22.1 days, mean diagnosis interval was 3.3 days, and mean initiation of treatment interval was 1.4 days. Patient delay was present in 34.8 percent of the patients. The application interval was shorter for patients hav- ing an index case for tuberculosis (p=0.039) and for those with good economic status (p<0.005). 167 patients (81.9%) had institutional delay. The referral interval was longer for female patients than for male patients (p=0.015). The most common causes of institutional delays were a low index of suspicion for tuberculosis, health care system delays, and underuti- lized chest X-ray examinations. One hundred and three patients (50.5%) had delays in diag- nosis and 51 patients (25.0%) had delays in treatment. The most frequent reason for diagnos- tic delay was health care system delays (35.9%). Conclusions: There were several delays in the diagnosis of tuberculosis patients. For an effective tuberculo- sis control, efforts should be made to reduce these delays. Physicians and the public should be educated about tuberculosis. Health care system and laboratory delays should be improved. key words: delays • smear-positive • pulmonary tuberculosis • diagnosis, treatment Full-text PDF: http://www.MedSciMonit.com/pub/vol_10/no_2/3261.pdf Word count: 2347 Tables: 5 Figures: 1 References: 26 Received: 2002.11.07 Accepted: 2003.07.03 Published: 2004.02.01 Author’s address: Dr. Adnan Yilmaz, Maltepe Zümrütevler Atatürk Cad. Abant Apt. No:30 81530 Istanbul, Turkey, e-mail: elifim@rt.net.tr Authors’ Contribution: A Study Design B Data Collection C Statistical Analysis D Data Interpretation E Manuscript Preparation F Literature Search G Funds Collection