Trends of delays in tuberculosis case finding in Japan and associated factors.
METHODS
Nationwide tuberculosis (TB) registry in Japan, 1987-2002.


OBJECTIVE
To clarify the trends of patient's delay (PD), doctor's delay (DD) and total delay (TD), their relation and factors associated with the delays.


METHODS
Longitudinal study on trends in delays. Among patients with symptomatic smear-positive pulmonary TB, those with long PD (> or =2 months), DD (> or =1 month) and TD (> or =3 months) were analysed.


RESULTS
Long PD rates increased until around 1997, whereas long DD rates decreased markedly from 1995 to 1999. Long TD rates increased until 1997, and decreased slightly thereafter. Men aged 30-59 years had higher rates of long PD, and the long PD rates increased through the 16-year observation period. Day labourers receiving or applying for welfare benefit had the highest rate of long TD, 46.5% during 1995-2002. Teachers and medical doctors showed the greatest increase in long TD rates through the period.


CONCLUSIONS
Long TD was influenced more by PD than DD, and showed an upward trend. However, the long TD rate has declined slightly owing to the recent reduction in long DD. The reduction in DD since 1995 occurred immediately after the introduction of new technology in bacteriological examinations.
Ohmori
M
M
Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose, Tokyo, Japan. ohmori@jata.or.jp
Ozasa
K
K
Mori
T
T
Wada
M
M
Yoshiyama
T
T
Aoki
M
M
Uchimura
K
K
Ishikawa
N
N
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009790:Occupations; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*