title: Impact of diabetes on diagnostic delay for pulmonary tuberculosis in Beijing.
abstract: METHODS
  Delays in the diagnosis of pulmonary tuberculosis (PTB) increase the risk of transmission and severity of the disease. Little information is available on PTB patients with diabetes mellitus (DM).
  
  
  OBJECTIVE
  To examine the impact of DM on delays in diagnosing PTB and the effect of diagnostic delay on the clinical presentation of PTB among patients in Beijing, China.
  
  
  METHODS
  In a cross-sectional study conducted in two PTB dispensaries of Beijing, all confirmed PTB patients were screened for DM. Data relating to diagnostic delay and clinical presentation of PTB were collected and analysed.
  
  
  RESULTS
  Of 1126 PTB patients selected, 182 (16.2%) were identified as having DM. The median delay for PTB patients with DM (25 days) was significantly higher than that of PTB patients without DM (6 days). In a subgroup analysis, diagnostic delay was associated with smear positivity among PTB patients with DM (OR 3.10, 95%CI 1.66-5.76) and associated with smear positivity (OR 4.38, 95%CI 3.19-6.04), pulmonary cavities (OR 2.62, 95%CI 1.85-3.71) and more symptoms (OR 1.81, 95%CI 1.20-2.73) among PTB patients without DM.
  
  
  CONCLUSIONS
  DM was associated with longer diagnostic delays, which in turn was associated with more serious clinical presentations of PTB. It is thus necessary to examine risk factors associated with diagnostic delay among PTB patients with and without DM.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: H-G
authors.initials: HG
authors.lastname: Chen
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: M
authors.initials: M
authors.lastname: Liu
authors.affiliation: National Center for Tuberculosis Control and Prevention, China Center for Disease Control and Prevention, Beijing, China.
authors.forename: S-W
authors.initials: SW
authors.lastname: Jiang
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: F-H
authors.initials: FH
authors.lastname: Gu
authors.affiliation: Fangshan Dispensary, Beijing, Fangshan District, China.
authors.forename: S-P
authors.initials: SP
authors.lastname: Huang
authors.affiliation: Changping Dispensary, Beijing, Changping District, China.
authors.forename: T-J
authors.initials: TJ
authors.lastname: Gao
authors.affiliation: Changping Dispensary, Beijing, Changping District, China.
authors.forename: Z-G
authors.initials: ZG
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001431:Bacteriological Techniques; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission