Patient and doctor delays in smear-negative and smear-positive pulmonary tuberculosis patients attending a referral hospital in Istanbul, Turkey.
OBJECTIVE
To measure delays from onset of symptoms to initiation of treatment in patients with smear-negative and smear-positive pulmonary tuberculosis and to identify reasons for these delays.


METHODS
A total of 136 newly diagnosed pulmonary tuberculosis patients were interviewed using a structured questionnaire.


RESULTS
The patients were divided into two groups. Group 1 included 65 smear-negative patients. There were 71 smear-positive patients in group 2. The median application interval was 10 days in group 1 and 14 days in group 2. While 24.6% of the patients had patient delay in group 1, patient delay was present in 33.8% of the patients in group 2 (P > 0.05). The median health care system interval was 41 days in group 1 and 16 days in group 2 (P < 0.0001). The most common reason for patient delay was neglect of symptoms by patient in both groups. A low index of suspicion for tuberculosis by physicians was the most common reason for doctor delays.


CONCLUSIONS
Delays are common problem in smear-negative and smear-positive pulmonary tuberculosis patients. Delays should be reduced to reach an effective tuberculosis control. Education of public and physicians about tuberculosis is the most important effort to reduce delays.
Department of Pulmonology, Sureyyapasa Center for Chest Diseases and Thoracic Surgery Training and Investigation Hospital, 34854 Istanbul, Turkey.
Gulbanu Horzum
GH
Ekinci
Department of Pulmonology, Sureyyapasa Center for Chest Diseases and Thoracic Surgery Training and Investigation Hospital, 34854 Istanbul, Turkey.
Esra
E
Karakaya
Department of Pulmonology, Sureyyapasa Center for Chest Diseases and Thoracic Surgery Training and Investigation Hospital, 34854 Istanbul, Turkey.
Esra Akkutuk
EA
Ongel
Department of Pulmonology, Sureyyapasa Center for Chest Diseases and Thoracic Surgery Training and Investigation Hospital, 34854 Istanbul, Turkey.
Osman
O
Haciomeroglu
Department of Pulmonology, Sureyyapasa Center for Chest Diseases and Thoracic Surgery Training and Investigation Hospital, 34854 Istanbul, Turkey.
Adnan
0000-0002-2427-3383
A
Yilmaz
D000293:Adolescent; D000368:Aged; D003581:Cytodiagnosis; D057210:Delayed Diagnosis; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000254:growth & development*; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology / Q000503:physiopathology