title: Delay in tuberculosis diagnosis and treatment in four provinces of Argentina.
abstract: METHODS
  Public health care services in the provinces of Buenos Aires, Santa Fe, Jujuy and Santa Cruz, Argentina.
  
  
  OBJECTIVE
  To evaluate delays in tuberculosis (TB) diagnosis and treatment and associated risk factors in departments and administrative areas of four Argentine provinces.
  
  
  METHODS
  Cross-sectional survey including retrospective medical record review and patient interviews.
  
  
  RESULTS
  A total of 243 patients with smear-positive pulmonary TB and a mean age of 40 years were included in the study. The mean diagnostic delays were as follows: total delay 92.1 days (median 62.0); patient delay 58.8 days (median 31); health service delay 32.6 days (median 12.5). The mean treatment delay was 0.9 days (median 0). Associations were observed between patient delays of >30 days and residence in Jujuy, age >50 years, dependence on transport to the nearest public health service due to distance and presence of cough. The >60-day total diagnosis delay was associated with age >50 years and need for transport to the nearest public health service.
  
  
  CONCLUSIONS
  Diagnostic delay is an important problem in the areas studied, with patient delay being of most concern. Patient delay was associated with age >50 years, dependence on transport to the nearest public health service due to distance and presence of cough.
authors.affiliation: National Institute of Respiratory Diseases Dr. Emilio Coni (ANLIS), Santa Fe, Argentina. elsazerbini@arnet.com.ar
authors.forename: E
authors.initials: E
authors.lastname: Zerbini
authors.forename: M C
authors.initials: MC
authors.lastname: Chirico
authors.forename: B
authors.initials: B
authors.lastname: Salvadores
authors.forename: B
authors.initials: B
authors.lastname: Amigot
authors.forename: S
authors.initials: S
authors.lastname: Estrada
authors.forename: G
authors.initials: G
authors.lastname: Algorry
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001118:Argentina / Q000453:epidemiology; D001431:Bacteriological Techniques; D002648:Child; D003371:Cough / Q000382:microbiology; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D006297:Health Services Accessibility; D006801:Humans; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D010342:Patient Acceptance of Health Care; D012111:Residence Characteristics; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology*; D013997:Time Factors; D014187:Transportation of Patients; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents