[Investigation on "patient's delay" in TB detection].
OBJECTIVE
The causes of delay in receiving medical examinations (for a period of more than 2 months between the appearance of tuberculosis symptoms and the first examination at a medical institution) were investigated.


METHODS
Interviews of 127 smear positive pulmonary tuberculosis patients (study period: June-December, 2008). Subjects were divided into 2 groups: those who showed delay in receiving medical examination (hereinafter referred to as "case") and those who did not show delay in receiving medical examination (hereinafter referred to as "control"), and the factors causing differences between the two groups were investigated.


RESULTS
There were 44 case examples and 83 control examples. There were higher rates of "aged under 60", "employed" and "have no family doctor" among cases, however, none of them were statistically significant. The rate of smokers was significantly higher in cases. At the time of diagnosis, chest X-ray findings were significantly aggravated in cases and cases were also significantly higher in the degree of smear positivity. It was mostly cases that replied "they were not the symptoms of a serious illness" concerning the initial symptoms and, concerning the timing of medical examinations, the reply "I was busy at work and couldn't take time off" was significantly higher.


CONCLUSIONS
It is considered that cases do not take symptoms seriously and that many of them do not receive medical examinations. Further, it is also considered necessary to carefully educate smokers in particular. There were many cases diagnosed as serious on chest X-ray findings and showed higher degree of smear positivity, so it is considered important to reduce delays in receiving medical examinations in order to treat patients early and prevent the spread of infection.
Matsumoto
Kenji
K
Health and Welfare Center of Nishinari Ward, Osaka City, 1-5-20, Kishinosato, Nishinari-ku, Osaka-shi, Osaka 557-8501 Japan. ke-matsumoto@city.osaka.lg.jp
Fukunaga
Yoshie
Y
Monbayashi
Junko
J
Arima
Kazuyo
K
Shimouchi
Akira
A
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D012907:Smoking / Q000523:psychology; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis*