title: [Determinants of tuberculosis diagnosis delay in limited resources countries].
abstract: BACKGROUND
  Delayed diagnoses of pulmonary tuberculosis contribute to the spread of the epidemic.
  
  
  METHODS
  This study aims to identify risk factors associated with patient delay (from symptoms onset to the first visit), health system delay (from the first visit to the tuberculosis treatment initiation) and total delay (sum of the patient and the health system delay) in low income and high tuberculosis burden countries. A systematic literature review has been performed using the keywords: "tuberculosis"; "delay", care seeking"; "health care seeking behavior"; "diagnosis" and "treatment". Only quantitative studies showing delays for pulmonary tuberculosis adult cases were included in this review.
  
  
  RESULTS
  Low income, gender, rural life, unemployment, ageing and misunderstanding the microbial cause of tuberculosis are associated with delayed diagnoses. Systemic factors including low health care coverage, patient expenditures and entry into the health system by consulting a traditional healer or a non-skilled professional delay the beginning of tuberculosis treatment.
  
  
  CONCLUSIONS
  Delays can be used as indicators to evaluate tuberculosis control programs. Active case finding in the households of contagious patients can help to diminish diagnostic delays in low-income countries with high endemicity.
authors.affiliation: Inserm UMRS 707, 27, rue de Chaligny, 75012 Paris, France. ndeindo.ndeikoundam_ngangro@etu.upmc.fr
authors.forename: N
authors.initials: N
authors.lastname: Ndeikoundam Ngangro
authors.forename: P
authors.initials: P
authors.lastname: Chauvin
authors.forename: V
authors.initials: V
authors.lastname: Halley des Fontaines
mesh_terms: D000328:Adult; D057210:Delayed Diagnosis; D003695:Delivery of Health Care; D003906:Developing Countries; D005260:Female; D006295:Health Resources / Q000600:supply & distribution*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D012959:Socioeconomic Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology