title: Referral times of Vietnamese refugees with tuberculosis in camps in Hong Kong.
abstract: METHODS
  Two closed camps in Hong Kong for Vietnamese refugees.
  
  
  OBJECTIVE
  To determine the referral times by clinicians (doctor's delay) of cases of tuberculosis (TB) from refugee camp clinics to the hospital/chest clinic.
  
  
  METHODS
  Retrospective case-note study of 97 Vietnamese patients receiving treatment for tuberculosis.
  
  
  RESULTS
  The sites of TB were pulmonary (n = 61), glandular (n = 15), pleural effusion (n = 15), and other (n = 6). The median referral time was 18 days (range 0-417). Median consultations numbered three (range 1-16). Fifty-three (54.6%) patients were prescribed antibiotics. Thirty-nine (40%) patients were referred within 10 days; of these, 18 were referred the same day. These 39 patients were less likely to have received antibiotics (9/39 [23.1%] vs 44/58 [75.9%], relative risk [RR] 0.3 95% confidence interval [CI] 0.17-0.55), but were equally likely to have been physically examined (RR 0.66, 95%CI 0.39-1.1). Sixteen (16.5%) patients were referred after 90 days. They attended the clinic more often (median attendances 6.5 vs 3, P = 0.0002), and were prescribed more antibiotic courses (mean antibiotic prescriptions 1.6 vs 0.7, P = 0.03).
  
  
  CONCLUSIONS
  Referral times by these clinicians varied widely, with long delays for approximately 60% of patients. Guidelines pertinent to primary care clinicians are needed to heighten their awareness of tuberculosis to prevent referral delays and subsequent TB treatment.
authors.affiliation: The British Red Cross Society, Hong Kong. bobbo1@compuserve.com
authors.forename: W R
authors.initials: WR
authors.lastname: Taylor
authors.forename: A
authors.initials: A
authors.lastname: Zumla
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000193:education / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012036:Refugees / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology*; D014744:Vietnam / Q000208:ethnology
chemical_list: D000995:Antitubercular Agents