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 FACTORS AFFECTING DELAY IN DIAGNOSIS OF COLORECTAL CANCER: A CROSS-SECTIONAL STUDY; FROM TERTIARY CARE HOSPITAL OF KARACHI PAKISTAN

2021 ◽  
Author(s):  
Rubab Nafees Ahmed ◽  
Lajpat Rai ◽  
Khursheed Ahmed Samo ◽  
Summaya Saeed ◽  
Ammara Salam ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Control Program ◽  
Cross Sectional Study ◽  
Diagnosis Delay ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Presenting Symptoms ◽  
Keywords Colorectal Cancer

Background: CRC incidence is increasing in our region. There is no specific CRC control program or national cancer registry in Pakistan. Previously no data has been published on presentation and diagnosis delay of CRC in our region. This study is conducted to determine the factor affecting delay in presentation and diagnosis and to provide baseline information to launch a CRC control program. Primary objective is to determine factor causing delay in diagnosis of CRC. Secondary objective is to evaluate relationship between tumor site and stage of CRC with presenting symptoms and symptom duration. Methods: This project is a prospective cross-sectional study on 113 biopsy-proven CRC patients admitted to the surgical ward of civil hospital Karachi. Results: A total number of participants was 113. Presentation delay was observed in 83.2% of patients. The main reasons for a reported delay in the presentation were lack of patients’ knowledge that these symptoms may be cancer (60.4%), the wrong diagnosis by the primary physician (34.6%), or the patient didn’t want to visit the doctor (0.04%). Most tumors (95%) originated from the sigmoid and rectum. 38.9% and 44.2% of the patients diagnosed at Stage 4 and 3 respectively. Conclusions: This study revealed that CRC patients in Pakistan are facing delays in presentation and diagnosis. This is the reason behind diagnosis at the advanced stage with a poor prognosis. Based on this study findings CRC control program should be introduced to detect CRC at an early stage. Keywords: Colorectal cancer, Colon, Rectum, Cancer, Presentation delay, Diagnosis delay.

scholarly journals Health seeking behavior and reasons for “patient‐related” diagnostic delay among pulmonary tuberculosis suspects attending designated microscopy centre of medical college in rural Puducherry

2017 ◽  
Vol 4 (4) ◽  
pp. 1314 ◽  
Author(s):  
Srikakarlapudi V. V. Subhadra Pranavi ◽  
Venkatesan Murugan ◽  
Ganapathy Kalaiselvan
Keyword(s):  
Diagnostic Delay ◽  
Control Program ◽  
Cross Sectional Study ◽  
Health Seeking ◽  
Cross Sectional ◽  
Health Seeking Behavior ◽  
Delay In Diagnosis ◽  
Medical College ◽  
Client Factors ◽  
Seeking Behavior

Background: The main strategy of modern TB control is early detection and treatment of sources of infection to reduce the duration of infectiousness. Delay in diagnosis has health provider factors and client factors. Health seeking behavior and reasons for TB diagnostic delay is important and which is one of the agenda for operational research under Revised National Tuberculosis Control Program (RNTCP). Methods: The present cross sectional study was conducted among 200 tuberculosis suspects attending the Designated Microscopy centre (DMC) of SMVMCH for a period of 2 months. Data was collected using a pre-designed questionnaire including sociodemographic details, health seeking behaviour, treatment delay and reasons for delay. Collected data was entered and analyzed in EPI_INFO (3.4.3). Descriptive statistics and significant association was established by the use of odd’s ratio with 95% confidence interval. Results: Among the study subjects most of them were between the age group of 15 to 60 years and majority of them were male. Symptoms about tuberculosis was known only to 40(20%) of the suspects and 85(42.5%) accepted that tuberculosis is a curable disease. Among the various factors leading to patient related diagnostic delay age, marital status and multiple symptoms shows significant association. The most common reason for the delay is not aware of the severity of the symptoms 126(63%). Conclusions: There is poor knowledge about tuberculosis, its modes of spread and symptoms among Tb suspects. Patient related delays also common among them which warrant need for public health interventions to improve it. 

scholarly journals Delayed Diagnosis of Hidradenitis Suppurativa and Its Effect on Patients and Healthcare System

Dermatology ◽  
2020 ◽  
Vol 236 (5) ◽  
pp. 421-430 ◽  
Author(s):  
Georgios Kokolakis ◽  
Kerstin Wolk ◽  
Sylke Schneider-Burrus ◽  
Stefanie Kalus ◽  
Sebastian Barbus ◽  
...  
Keyword(s):  
Healthcare System ◽  
Inflammatory Disease ◽  
Hidradenitis Suppurativa ◽  
Severe Disease ◽  
Delayed Diagnosis ◽  
Chronic Inflammatory Disease ◽  
Purulent Discharge ◽  
Diagnosis Delay ◽  
Cross Sectional ◽  
Delay In Diagnosis

Background: Hidradenitis suppurativa (HS) is a neglected chronic inflammatory disease with long delay in diagnosis. Besides pain, purulent discharge, and destruction of skin architecture, HS patients experience metabolic, musculoskeletal, and psychological disorders. Objectives: To determine the delay in HS diagnosis and its consequences for patients and the healthcare system. Methods: This was a prospective, multicenter, epidemiologic, non-interventional cross-sectional trial carried out in Germany and based on self-reported questionnaires and medical examinations performed by dermatologists. In total, data of 394 adult HS patients were evaluated. Results: The average duration from manifestation of first symptoms until HS diagnosis was 10.0 ± 9.6 (mean ± SD) years. During this time, HS patients consulted on average more than 3 different physicians – most frequently general practitioners, dermatologists, surgeons, gynecologists – and faced more than 3 misdiagnoses. Diagnosis delay was longer in younger and non-smoking patients. In most cases, HS was correctly diagnosed by dermatologists. The longer the delay of diagnosis, the greater the disease severity at diagnosis. Delayed HS diagnosis was also associated with an increased number of surgically treated sites, concomitant diseases, and days of work missed. Conclusion: This study demonstrates an enormous delay in the diagnosis of HS, which results in more severe disease. It also shows for the first time that a delay in diagnosis of a chronic inflammatory disease leads to a higher number of concomitant systemic disorders. In addition to the impaired health status, delayed diagnosis of HS was associated with impairment of the professional life of affected people.

scholarly journals Place & Person involved in delivery: Factors leading to delay in diagnosis of Anorectal Malformation in Newborns

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Shazia Perveen ◽  
Sajid Ali ◽  
Abdul Jabbar ◽  
Batool Fatima
Keyword(s):  
Anorectal Malformation ◽  
Delayed Diagnosis ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Paediatric Surgery ◽  
Chi Square ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Creative Commons ◽  
Medical Person

Objective: To determine the frequency of place of delivery and person detecting the anomaly among newborn babies presenting with delayed diagnosis of anorectal malformation (ARM). Methods: This is a Descriptive Cross-Sectional Study, conducted at Department of Paediatric Surgery, National Institute of Child Health (NICH) Karachi, from February 19, 2019 to August 18, 2019. All patients with ARM who were diagnosed beyond two hours of life (Delayed diagnosis) were included in the study. Chi square test was applied for comparison of categorical variables. Results: Total 110 patients were enrolled in this study. Nineteen (17.3%) patients were delivered at home, while 91 (82.7%) were delivered at the hospital. The first person detecting the anomaly was grandmother (n=25) or a non-medical person in 58 patients (52.7%), 52 were diagnosed by a medical personal either primarily in 31 cases (28.2%) or secondarily by a neonatologist in 21 cases (19.1%). Conclusion: It is concluded that Non-medical person detected ARM mainly despite the babies being delivered mostly at the hospital, indicating the need for meticulous neonatal examination. doi: https://doi.org/10.12669/pjms.38.1.4156 How to cite this:Perveen S, Ali S, Jabbar A, Fatima B. Place & Person involved in delivery: Factors leading to delay in diagnosis of Anorectal Malformation in Newborns. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4156 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals A patients’ view of OA: the Global Osteoarthritis Patient Perception Survey (GOAPPS)

2020 ◽  
Author(s):  
Marianna Vitaloni ◽  
Angie Botto-van Bemden ◽  
Rosa Sciortino ◽  
Xavier Carné ◽  
Maritza Quintero ◽  
...  
Keyword(s):  
Value Chain ◽  
Online Survey ◽  
Task Force ◽  
Active Role ◽  
Cross Sectional Study ◽  
Patient Perception ◽  
Cross Sectional ◽  
Data Set ◽  
Surgical Treatments ◽  
Perception Survey

Abstract Background: Globally, osteoarthritis (OA) is the third condition associated with disability. There is still poor treatment in OA but science holds the key to finding better treatments and a cure. It is essential to learn what’s important to patients from them to implement the most effective OA management. The OA Patients Task Force, conducted the Global OA Patient Perception Survey (GOAPPS)-the first global survey to compare the quality of life (QoL) & patient perceptions of care across countries. The goal was to collect data on OA patients' perception of OA to understand patients’ needs and expectations to improve OA management.Methods: Observational, cross-sectional study by online survey data collection from six countries, translated into three languages. The survey was comprised of 3 sections: patient demographics and clinical symptomology characteristics; relationship with physicians: perception of attention, treatment, and information provided; and OA impact on daily activity and QoL. The results of the survey were evaluated using the Limited Data Set. The survey results were analyzed using descriptive statistics to characterize the patients' answers using the IBM SPSS® software.Results. A total of 1512 surveys were completed in 6 countries. 84.2% of respondents reported pain/tenderness and 91.1% experienced limitations to physical activities. 42.3% of patients were not satisfied with their current OA treatment. 86% had comorbidities, especially hypertension, and obesity. 51.3% and 78% would like access to additional drug or additional non-drug/non-surgical treatments respectively. 48.2% of patients perceived their QoL to be affected by OA Conclusions: OA has a significant impact on patients’ daily activities and their desire to play an active role in managing this disease. Patients are seeking additional treatments, especially no pharmacological/no surgical treatments stressing the need for investing in clinical research, implementing OA preventive measures, and managing interventions to improve the healthcare value chain in OA.

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.

scholarly journals Delay in Diagnosis of Pulmonary Tuberculosis is Associated with Increased Risk of Transmission in Pastoralist Setting, Ethiopia

2019 ◽  
Author(s):  
Fentabil Getnet ◽  
Meaza Demissie ◽  
Alemayehu Worku ◽  
Tesfaye Gobena ◽  
Berhanu Seyoum ◽  
...  
Keyword(s):  
Control Strategies ◽  
Multivariable Analysis ◽  
Predictive Ability ◽  
Cross Sectional Study ◽  
Diagnosis Delay ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Delay In Diagnosis ◽  
Sputum Microscopy ◽  
Increased Risk

Abstract Background To comprehend the effect of delayed care on risk of tuberculosis (TB) transmission in a TB prevalent but low case detection area, this study examined the association of diagnosis delay with patient infectiousness (cavitation and smear positivity) and determined the threshold delay that optimizes infectiousness. It also assessed transmission drivers in Somali region of Ethiopia, an area with ample pastoralist population. Methods A cross-sectional study was conducted using 434 new pulmonary TB patients, aged ≥15 years, who were recruited prospectively in five major facilities between December 2017 and October 2018. Data were collected on delays in diagnosis, socio-demographics, clinical and epidemiological information using interview, record-review, anthropometry, sputum microscopy and chest radiography techniques. Log-binomial regression models were used to reveal predictors of cavitation and smear positivity at p<0.05 using Stata/SE®14. C-statistics was applied to determine predictive ability and threshold delay that classifies infectiousness. Results Median age of participants was 30 years. Majorities were male (62.9%), nearly half (46.5%) were pastoralist and 2.3% TB/HIV co-infected. Median delay from debut of illness to diagnosis was 49 days (IQR=37). Among all cases, 45.6% [95%CI: 40.9-50.4] had pulmonary cavity and 42.0% [95%CI: 37.3˗46.9] were smear positive. On multivariable analysis, cavitation was higher in patients delayed over a month [P<0.001], ≤35 years [APR (95%CI) =1.3(1.01-1.6)], with 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 higher in patients delayed >49 days [p=0.02], ≤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)]. Delay discriminates cavitation [AUC (95%CI) =0.67(0.62-0.72)] at 43 days optimal cutoff and 74.6% sensitivity. Conclusion This study highlights that delay in diagnosis of pulmonary TB remains high and is associated with increased risk of cavitation and smear positivity in pastoral setting in Ethiopia. In pastoral settings, this may call upon a socio-cultural tailored TB prevention and control strategies.

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.

Time delay barriers in diagnosis and treatment of gastrointestinal cancer in Nepal.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19085-e19085
Author(s):  
Soniya Dulal ◽  
Bishnu D. Paudel ◽  
Prakash C. Neupane ◽  
Bibek Acharya ◽  
Sandhya Chapagain Acharya ◽  
...  
Keyword(s):  
Rural Areas ◽  
Safety Net ◽  
Cross Sectional Study ◽  
Medical Consultation ◽  
Diagnosis And Treatment ◽  
Diagnosis Delay ◽  
Self Medication ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Gi Cancers

e19085 Background: Gastrointestinal (GI) cancers represent a major health challenge worldwide including in Nepal where patients (pts) often present with advanced disease and outcomes are poor. The purpose of this study was to quantify and to determine the causes of delay in diagnosis and treatment of GI cancer pts in Nepal. Methods: An IRB-approved cross sectional study was performed in pts with GI cancers at safety net Bir Hospital, Kathmandu, Nepal. All diagnosed consenting pts, both in- and out-pts, were enrolled. Pts were interviewed with a standardized questionnaire from July 2018 to June 2019. The caregivers were allowed to answer on behalf of illiterate pts. Diagnosis delay was defined as days from first symptoms to pathological diagnosis. Patient delay was defined as days from first symptoms to first medical consultation. Treatment delay was defined as days from diagnosis to surgery and/or treatment by medical/radiation oncologist. Differences in median times to delay were compared with two-tailed t-tests (Prism 8.0) based on the identified potential causes of delays. Results: The median age at diagnosis was 53.5 (22-77) years and 62% were males; 46% were farmers, 29% were housewives, and the rest had various occupations. 73% were outpatient at diagnosis. 46% had gastroesophageal cancer (gastric – 38%; esophagus – 8%) and 54% had colorectal cancer (left sided colon - 23%, right sided colon -13%; rectum 18%). No patients with anal or small bowel cancer were identified. 84% presented with Stage III/ IV disease. 68% were illiterate, 89% had a history of self-medication prior to first medical consultation, 74% were from rural areas with limited healthcare facilities and 79% were unaware of causes of GI cancers. Only self-medication was associated with delays in diagnosis and patient delays (Table). Conclusions: Self-medication rather than seeking help from medical professionals led to significant delays in the diagnosis of GI cancers in Nepal. Reasons for these decisions will be explored in future studies and may be amenable to efforts such as lay navigation. [Table: see text]

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.

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