Delay in the diagnosis and treatment of pulmonary tuberculosis in patients attending a university teaching hospital.
METHODS
University Hospital, Kuala Lumpur, Malaysia.


OBJECTIVE
To investigate patient and doctor delays in the diagnosis and treatment of pulmonary tuberculosis in patients attending a tertiary teaching hospital.


METHODS
A total of 97 patients with newly diagnosed pulmonary tuberculosis at our hospital were interviewed to study the process of case-finding since the onset of symptoms. Time intervals between onset, first medical consultation and the final diagnosis and commencement of antituberculosis treatment were determined. Demographic and clinical features were evaluated for their effect on these intervals.


RESULTS
36 cases were sputum smear-positive and 61 were smear-negative. Tuberculosis was eventually confirmed in 32 of the smear-negative cases. The medians of patient delay, doctor delay and total delay were 2 weeks, 7 weeks and 12.5 weeks, respectively. The majority of the patients consulted private general practitioners but the diagnosis of tuberculosis was rarely suspected; chest X-ray and sputum examinations were under-utilized.


CONCLUSIONS
To shorten patient delay the public should be educated about the symptoms of tuberculosis and the importance of early medical consultation. Private general practitioners should be more alert to the diagnostic possibility of tuberculosis and refer the patients promptly to the government hospitals for appropriate investigation.
Liam
C K
CK
Department of Medicine, University Hospital, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Tang
B G
BG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use; D003906:Developing Countries; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D006784:Hospitals, Teaching; D006785:Hospitals, University; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000706:statistics & numerical data; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data
D000995:Antitubercular Agents