scholarly journals Total, Patient and System Diagnostic Delays for Pulmonary Bacilliferous Tuberculosis in the Six Diagnostic and Treatment Centers in the Five Health Districts of the Central Region, Burkina Faso, 2018

2022 ◽  
Author(s):  
Pauline Kiswendsida Yanogo ◽  
Clarisse Balima ◽  
Nicolas Meda
Keyword(s):  
Pulmonary Tuberculosis ◽  
Burkina Faso ◽  
Central Region ◽  
Diagnostic Delay ◽  
Cross Sectional Study ◽  
Diagnosis Delay ◽  
Cross Sectional ◽  
Total Patient ◽  
Number Of Patients ◽  
Health Districts

Abstract Introduction Long diagnosis delay contributes significantly to the failure to eradicate tuberculosis. The objective of this study was to evaluate the total, patient and system delays in diagnosis of pulmonary bacilliferous in the six tuberculosis Diagnostic and Treatment Centers in the five health districts of the central region in Burkina Faso. Methods A descriptive cross-sectional study was conducted among 384 microscopy-positive pulmonary tuberculosis patients in 2018 to address this objective. It concerned the socio-demographic, clinical, microbiological characteristics, and referral location/pathway characteristics of the patients. We then calculated the different delays. The “patient” (time from first symptoms to first consultation), “system” (time from first consultation to first diagnosis) and total (time from first symptoms to diagnosis) median diagnostic delay were estimated. Results The median “total”, “patient” and “system” diagnostic times were 37, 21 and 7 days, respectively. Of the 384 patients surveyed, 158 patients or 41.25% of patients had a long total diagnostic delay (> 45 days). The number of patients with a long system diagnostic delay was 125 patients (32.55%; p < 0.001) and those with a long patient diagnostic delay were 105 patients (27.34%; p < 0.001). Conclusion The total diagnosis delay of pulmonary tuberculosis was long for almost half of the patients. Awareness of the signs of tuberculosis among patients and caregivers, and consultation in a health center must be intensified to help considerably reduce these delays.

scholarly journals Gender and time delays in diagnosis of pulmonary tuberculosis: a cross-sectional study from China

2019 ◽  
Vol 147 ◽  
Author(s):  
H. G. Chen ◽  
T. W. Wang ◽  
Q. X. Cheng
Keyword(s):  
Gender Differences ◽  
Pulmonary Tuberculosis ◽  
Rural Areas ◽  
Diagnostic Delay ◽  
Cross Sectional Study ◽  
Diagnosis Delay ◽  
Sectional Study ◽  
Short Delay ◽  
Cross Sectional ◽  
Increased Risk

AbstractGender inequality has severe consequences on public health in terms of delay in diagnosis of pulmonary tuberculosis (PTB). In order to explore gender-related differences in diagnosis delay, a cross-sectional study of 10 686 patients diagnosed with PTB in Yulin from 1 January 2009 to 31 December 2014 was conducted. Diagnosis delay was categorised into ‘short delay’ and ‘long delay’ by four commonly used cut-off points of 14, 30, 60 and 90 days. Logistic regression analysis was used to analyse gender differences in diagnostic delay. Stratified analyses by smear results, age, urban/rural were performed to examine whether the effect persisted across the strata. The median delay was 31 days (interquartile range 13–65). Diagnostic delay in females at cut-off points of 14, 30, 60 and 90 days had odds ratios (OR) of 0.99 (95% CI 0.91–1.09), 1.09 (95% CI 1.01–1.18), 1.15 (95% CI 1.05–1.26) and 1.18 (95% CI 1.06–1.31), respectively, compared with males. Stratified analysis showed that females were associated with increased risk of longer delay among those aged 30–60 years, smear positive and living in the rural areas (P < 0.05). The female-to-male OR increased along with increased delay time. Further inquiry into the underlying reasons for gender differences should be urgently addressed to improve the current situation.

Endometriosis-Associated Symptoms and Diagnostic Delay: An Online Survey

2020 ◽  
Author(s):  
Maryam Moradi ◽  
Azin Niazi ◽  
Melissa Parker ◽  
Anne Sneddon ◽  
Violeta Lopez ◽  
...  
Keyword(s):  
Online Survey ◽  
Age Of Onset ◽  
Diagnostic Delay ◽  
Delayed Diagnosis ◽  
Cross Sectional Study ◽  
Diagnosis Delay ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Associated Symptoms ◽  
Surgical Treatments

Abstract Background: Endometriosis is found in women of all ethnic and social groups with a prevalence of around 10%. However, data on diagnostic-delay and associated symptoms are limited. The aim of this study was to determine the endometriosis-associated symptoms and diagnosis-delay through an online survey. Methods: A cross-sectional study was conducted in Australia using an online web-based survey. All data were entered and analyzed using STATA (version 14/1). A total of 903 responders completed an online survey from September 2013 to October 2015.Results: Total participants of 903, 71.10% Australians (were born in Australia) and 28.90% Non-Australian (were not born in Australia), with self-reported diagnosis of endometriosis was confirmed by surgery in 86.5% of participants completed the online survey. Delay in diagnosis was 8.1±6.2 years. There was no difference between age range (p = 0.35), mean age of onset of the first symptoms (p = 0.93), and delay in diagnosis (p = 0.11) in both groups. Most common endometriosis-related symptoms that all responders had experienced in their lifetime were period pain 98.11%, fatigue 94.01%, bloating 90.69%, ovulation pain 88.70%, pelvic pain 87.26%, pain during before/after sexual activity 82.72% and heavy bleeding 82.17% and delayed fertility 37.98%. Treatments used in affected women included: pain killers 96.01% (n=867), hormonal medication 84.71% and surgical treatments 84.49 %. Rate of miscarriage or stillbirth was 13.4% and hysterectomy because of endometriosis was 9.6%. Conclusions: Vast similarities in demographics and endometriosis-associated symptoms among the Australian and non-Australian women with endometriosis support the universality of the disease characteristics. Delay in diagnosis of endometriosis is a problem and the reasons for delayed diagnosis must be better understood to try to shorten this delay. Except for pain, endometriosis patients suffer from a variety of symptoms and treatment must take into account the most prominent symptoms.

scholarly journals Health seeking behaviour in pulmonary tuberculosis: a cross sectional study

2018 ◽  
Vol 5 (4) ◽  
pp. 1346 ◽  
Author(s):  
Jebamalar J. ◽  
Priya Senthilkumar ◽  
Mary Ramola
Keyword(s):  
Pulmonary Tuberculosis ◽  
Diagnostic Delay ◽  
Cross Sectional Study ◽  
Patient Delay ◽  
Diagnosis And Treatment ◽  
Sectional Study ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Cross Sectional ◽  
Tuberculosis Patients

Background: Health seeking behaviour has been identified as a complex and dynamic process which influences disease burden of tuberculosis. The present study aimed to study health seeking behaviour among pulmonary tuberculosis patients in a metropolitan city and to assess diagnostic and treatment delays and their determinants.Methods: A cross sectional study was conducted among newly diagnosed pulmonary tuberculosis patients registered for intensive phase of Category 1 ATT during the study period in Zone VIII of Chennai Corporation. The sample size was 197. The study was conducted over a period of one year from September 2015 to August 2016. A standardized WHO interview schedule on diagnostic delay was used for the study.Results: Patients sought healthcare for more severe symptoms like hemoptysis (delay of 38 days) earlier than for cough (delay o- 8 days). Other reasons for delay in seeking care were hope of self-resolution, financial constraints, fear of what the diagnosis would be, incompatible timings etcetera. The total mean delay from onset of symptoms till start of treatment was around 47 days, out of which the patient delay was 42 days. Factors significantly associated with delay included smoking, age more than 35 years and not approaching healthcare facilities first.Conclusions: An unacceptably high patient delay is the major contributor to total delay in the diagnosis and treatment of pulmonary tuberculosis patients. There is increased odds of delay among smokers compared to those who have never smoked. So smokers may be added to the high risk group for suspicion of tuberculosis for fast tracking of diagnosis and treatment. Furthermore, methods to curb over the counter medications should be explored.

scholarly journals Delay in diagnosis of pulmonary tuberculosis increases the risk of pulmonary cavitation in pastoralist setting of Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Fentabil Getnet ◽  
Meaza Demissie ◽  
Alemayehu Worku ◽  
Tesfaye Gobena ◽  
Rea Tschopp ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Diagnosis Delay ◽  
Discriminative Ability ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Factors Associated ◽  
Record Review

Abstract Background Delay in diagnosis and treatment of pulmonary tuberculosis (PTB) leads to severe disease, adverse outcomes and increased transmission. Assessing the extent of delay and its effect on disease progression in TB affected settings has clinical and programmatic importance. Hence, the aim of this study was to investigate the possible effect of delay on infectiousness (cavitation and smear positivity) of patients at diagnosis in Somali pastoralist area, Ethiopia. Methods A cross-sectional study was conducted between December 2017 and October 2018, and 434 newly coming and confirmed PTB patients aged ≥15 years were recruited in five facilities. Data were collected using interview, record-review, anthropometry, Acid-fast bacilli and chest radiography techniques. Log-binomial regression models were used to reveal the association of delay and other factors associated with cavitation and smear positivity, and ROC Curve was used to determine discriminative ability and threshold delays. Results Median age of patients was 30 years. Of all, 62.9% were males, and 46.5% were pastoralists. Median diagnosis delay was 49 days (IQR = 33–70). Cavitation was significantly associated with diagnosis delay [P < 0.001]; 22.2% among patients diagnosed within 30 days of illness and 51.7% if delay was over 30 days. The threshold delay that optimizes cavitation was 43 days [AUC (95% CI) = 0.67(0.62–0.72)]. Smear positivity was significantly increased in patients delayed over 49 days [p = 0.02]. Other factors associated with cavitation were age ≤ 35 years [APR (95% CI) =1.3(1.01–1.6)], chronic diseases [APR (95% CI) = 1.8(1.2–2.6)] and low MUAC*female [APR (95% CI) = 1.8(1.2–2.8)]. Smear positivity was also associated with age ≤ 35 years [APR (95% CI) =1.4(1.1–1.8)], low BMI [APR (95% CI) =1.3(1.01–1.7)] and low MUAC [APR (95% CI) =1.5(1.2–1.9)]. Conclusion This study highlights delay in diagnosis of pulmonary TB remained high and increased infectiousness of patients in pastoral settings of Ethiopia. Hence, delay should be targeted to improve patient outcomes and reduce transmission in such settings.

scholarly journals Factors Associated With Diagnostic Delay of Pulmonary Tuberculosis in China

2021 ◽  
Author(s):  
Caihong Xu ◽  
Xiaomeng Zhang ◽  
Yan Liu ◽  
Yinyin Xia ◽  
Li Wang ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Urban Areas ◽  
Clinical Symptoms ◽  
Public Awareness ◽  
Diagnostic Delay ◽  
Diagnosis Delay ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Major Barrier ◽  
Factors Associated

Abstract Background Tuberculosis (TB) is still a great challenge to public health in China. Most of the transmission occurs between the onset of symptoms and initiation of treatment. Diagnosis delay is a major barrier to effective management of the disease. Determining the factors associated with patient and provider delay of TB diagnosis and treatment may contribute to TB prevention and control.MethodsA cross-sectional survey of pulmonary tuberculosis registed in the National Tuberculosis programme was conducted in 22 counties of 6 provinces in China. All consecutively registered patients during January to June 2017 were interviewed using a structured questionnaire. The time from the onset of symptoms to the date of diagnosis was analyzed. Bivariate and logistics regression were applied to analyze the risk factors of delay.ResultsThe median time from onset of symptoms to diagnosis was 23 days (interquartile range [IQR]: 5-53days). The risk of delayed diagnosis was higher in the central (OR=3.27, 95%CI 1.39-7.68) and eastern regions (OR=1.48, 95%CI 1.04-2.10) than in the western regions. Rural TB patients have a longer diagnosis delay than those in urban areas (OR=1.44, 95%CI 1.00-2.08). The asymptomatic TB patients had a longer diagnosis delay than TB patients with clinical symptoms (OR=0.20, 95%CI 0.13-0.31).ConclusionsA high propotion of TB patients showed diagnostic delay in China especially in some low economic level areas. Multiple measures should be taken to shorten the delay, such as to increase public awareness of the disease and expansion the quality assured facility in economic less-developed regions.Trial registrationNot applicable

scholarly journals POS1274 THERAPEUTIC MANAGEMENT OF RHEUMATOLOGISTS VERSUS OTORHINOLARYNGOLOGISTS OF CERVICOGENIC DIZZINESS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 921.2-922
Author(s):  
M. Yasmine ◽  
K. Maatallah ◽  
H. Ferjani ◽  
W. Triki ◽  
D. Ben Nsib ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Treatment Approach ◽  
Cross Sectional Study ◽  
Treatment Modalities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Standard Assessment ◽  
Number Of Patients ◽  
Cervicogenic Dizziness ◽  
No Gold Standard

Background:The treatment of patients presenting with cervicogenic dizziness (CGD) may be challenging. Indeed, there is no consensual treatment approach for CGD, nor is there no gold-standard assessment for diagnosis.Objectives:Our study aimed to assess the management of CGD by rheumatologists versus otorhinolaryngologists.Methods:We conducted a cross-sectional study including Tunisian doctors dealing with CGD. Rheumatologists (RTO) and otorhinolaryngologists (ORL) were invited to answer a questionnaire via google form about CGD daily management. Outcomes of interest were treatment modalities.Results:The study included 30 RTO and 32 ORL. Most of the doctors (RTO, vs ORL) were females (88.3%, vs 56.3%), aged between 35 and 45 (43.3%, vs 62.5%), and worked at a private practice (33.3%, vs 59.4%). The number of patients diagnosed with CGD by RTO was as follows: 1-2 per year (33.3%), 1-2 per month (18.8%), 1-2 per week (20%), less than one patient a year (10%) and none in 3.3% of cases. The number of patients diagnosed with CGD by ORL was as follows: 1-2 per year (50%), 1-2 per month (33.3%), 1-2 per week (6.2%), less than one patient a year (15.7%) and none (9.4%). Most patients presenting with CGD were females in both groups (93.1%, vs 82.8% respectively) with a mean age between 36 and 65 (79.3%, vs 82.1%). Most of the respondents declared treating patients with CGD (93.1%, vs 79.1%). Regarding treatment modalities, physical therapy was the most prescribed in both specialties (81.5% and 48.3%, respectively). Only RTO (18.5%) prescribed manual therapy. Concerning medical treatment, anti-inflammatory were the most prescribed drugs in both groups (92.6, and 34.5%, respectively). Sixty-seven percent of RTO prescribed anti-vertigo medication. Interestingly, it was the least prescribed drug by ORL (6.9%). Only RTO (59.3%) prescribed Muscle relaxants.Conclusion:Despite the disparities in the management of CGD, physical therapy remains the first prescribed treatment by Tunisian doctors. Further studies are needed to establish a consensus to treat CGD.Disclosure of Interests:None declared

scholarly journals Evaluation of the performance of clinical predictors in estimating the probability of pulmonary tuberculosis among smear-negative cases in Northern Ethiopia: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037913
Author(s):  
Mala George ◽  
Geert-Jan Dinant ◽  
Efrem Kentiba ◽  
Teklu Teshome ◽  
Abinet Teshome ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Cross Sectional Study ◽  
Clinical Suspicion ◽  
Secondary Outcome ◽  
Northern Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative ◽  
Culture Positive ◽  
Culture Negative

ObjectivesTo evaluate the performance of the predictors in estimating the probability of pulmonary tuberculosis (PTB) when all versus only significant variables are combined into a decision model (1) among all clinical suspects and (2) among smear-negative cases based on the results of culture tests.DesignA cross-sectional study.SettingTwo public referral hospitals in Tigray, Ethiopia.ParticipantsA total of 426 consecutive adult patients admitted to the hospitals with clinical suspicion of PTB were screened by sputum smear microscopy and chest radiograph (chest X-ray (CXR)) in accordance with the Ethiopian guidelines of the National Tuberculosis and Leprosy Program. Discontinuation of antituberculosis therapy in the past 3 months, unproductive cough, HIV positivity and unwillingness to give written informed consent were the basis of exclusion from the study.Primary and secondary outcome measuresA total of 354 patients were included in the final analysis, while 72 patients were excluded because culture tests were not done.ResultsThe strongest predictive variables of culture-positive PTB among patients with clinical suspicion were a positive smear test (OR 172; 95% CI 23.23 to 1273.54) and having CXR lesions compatible with PTB (OR 10.401; 95% CI 5.862 to 18.454). The regression model had a good predictive performance for identifying culture-positive PTB among patients with clinical suspicion (area under the curve (AUC) 0.84), but it was rather poor in patients with a negative smear result (AUC 0.64). Combining all the predictors in the model compared with only the independent significant variables did not really improve its performance to identify culture-positive (AUC 0.84–0.87) and culture-negative (AUC 0.64–0.69) PTB.ConclusionsOur finding suggests that predictive models based on clinical variables will not be useful to discriminate patients with culture-negative PTB from patients with culture-positive PTB among patients with smear-negative cases.

scholarly journals Genotypic distribution of human oncogenic papillomaviruses in sexually active women in Burkina Faso: Central, Central-Eastern and Hauts-Bassins regions

2020 ◽  
Vol 11 (1) ◽  
pp. 125-136
Author(s):  
Rogomenoma Alice Ouedraogo ◽  
Théodora Mahoukèdè Zohoncon ◽  
Ina Marie Angèle Traore ◽  
Abdoul Karim Ouattara ◽  
Sindimalgdé Patricia Guigma ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Large Scale ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Sexually Active ◽  
Cervical Lesions ◽  
Cross Sectional ◽  
Genotypic Distribution ◽  
Hpv Genotypes ◽  
Central Eastern

AbstractObjectivethis study was conducted to determine the distribution of high-risk human papillomavirus (HR-HPV) genotypes in women in the general population of three regions of Burkina Faso.MethodThis multicenter, descriptive cross-sectional study involved 1321 sexually active women in five cities in three regions of Burkina Faso: Central, Central-Eastern and Hauts-Bassins regions. After collection of endocervical specimens, pre-cervical lesions were screened by visual inspection with acetic acid and lugol (VIA / VILI). HR-HPV genotypes were characterized by multiplex real-time PCR after extraction of viral DNA.ResultsThe mean age of women was 31.98 ± 10.09 years. The HR-HPV infection in the three regions ranged from 26.16% to 43.26% with 35.42% as overall prevalence in women. The most common HR-HPV genotypes in descending order were: HPV 56, 52, 66, 59, 39, 51, 18, 35. The prevalence of bivalent vaccine genotypes (HPV16 / 18) was 7.83% against 63.78% of genotypes not covered by HPV vaccine; 36.32% (170/468) of women had multiple concomitant HR-HPV infections.Conclusionthis study showed significant regional variation and high prevalence of HR-HPV infection in women. The predominant genotypes differ from those covered by available vaccines in Burkina Faso. These results will help guide our health policies towards better prevention of cervical cancer. The diversity of oncogenic genotypes is sparking a large-scale study in the West African sub-region, particularly in cases of cancer and the introduction of the nonavalent vaccine which includes HPV 52 found among the predominant genotypes in this study.

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