title: Determinants of consultation, diagnosis and treatment delays among new smear-positive pulmonary tuberculosis patients in Morocco: a cross-sectional study.
abstract: We conducted a cross-sectional survey in 2012 in 12 selected provinces and prefectures in Morocco to determine consultation delay (patient delay), diagnosis delay and treatment delay (health system delays), and factors relating to these delays. The sample included 250 eligible and consenting newly diagnosed smearpositive pulmonary tuberculosis patients who were interviewed at the time of their registration within Diagnosis of Tuberculosis and Respiratory Diseases Reference Centers (CDTMR) or Integrated Health Centers (CSI) using a pretested and structured questionnaire. The median total delay was 46 days [inter-quartile interval (IQI) = 29-84 days]. Patient delay (median = 20; IQI = 8-47 days) was higher than health system delay (median=15; IIQ = 7-35 days). Being illiterate, thinking symptoms will disappear by themselves; having financial constraints and feeling fear of diagnosis or social isolation were associated with patient delay. Consulting first in the private sector or having 3 or more consultations before diagnosis was associated with health system delay.
authors.affiliation: Institut National d'Administration Sanitaire, Programme FETP-Maroc, Rabat (Maroc).
authors.forename: M
authors.initials: M
authors.lastname: Akrim
authors.affiliation: Service des Maladies Respiratoires, Direction de l'Épidémiologie et de Lutte contre les Maladies, Rabat (Maroc).
authors.forename: K
authors.initials: K
authors.lastname: Bennani
authors.affiliation: Institut National d'Administration Sanitaire, Programme FETP-Maroc, Rabat (Maroc).
authors.forename: A
authors.initials: A
authors.lastname: Essolbi
authors.affiliation: Service des Maladies Respiratoires, Direction de l'Épidémiologie et de Lutte contre les Maladies, Rabat (Maroc).
authors.forename: M
authors.initials: M
authors.lastname: Sghiar
authors.affiliation: Institut National d'Administration Sanitaire, Programme FETP-Maroc, Rabat (Maroc).
authors.forename: A
authors.initials: A
authors.lastname: Likos
authors.affiliation: Service des Maladies Respiratoires, Direction de l'Épidémiologie et de Lutte contre les Maladies, Rabat (Maroc).
authors.forename: A
authors.initials: A
authors.lastname: Benmamoun
authors.affiliation: Service des Maladies Respiratoires, Direction de l'Épidémiologie et de Lutte contre les Maladies, Rabat (Maroc).
authors.forename: O El
authors.initials: OE
authors.lastname: Menzhi
authors.affiliation: Institut National d'Administration Sanitaire, Programme FETP-Maroc, Rabat (Maroc).
authors.forename: A
authors.initials: A
authors.lastname: Maaroufi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009018:Morocco; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D061665:Time-to-Treatment; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D055815:Young Adult