title: Patient and health system delays among adult smear-positive tuberculosis patients diagnosed at medical colleges of Puducherry in south India.
abstract: Early diagnosis and prompt initiation of treatment are essential for an effective tuberculosis (TB) control program. This study was done to assess the extent of various delays among TB patients diagnosed at medical colleges of Puducherry. A cross-sectional study involving retrospective medical record review and prospective patient interviews was conducted in and around the union territory of Puducherry during the period 2009-10. Various delays and adjusted odds ratios (ORs) were calculated. Level of significance was determined at 95% confidence interval (CI) (P value <0.05) and all tests were two-sided. Among 216 new sputum smear-positive TB patients, 11.1% and 10.6% were smokers and alcohol users, respectively. The median patient delay, health system delay, and total delay was 37 days, 28 days, and 65 days respectively. Being a resident of Puducherry (OR = 0.39, 95% CI = 0.18-0.87) and family size of ≤5 (OR = 0.45, 95% CI = 0.21-0.97) were found as the determinants of patient delays and total delays, respectively.
authors.forename: Anil Jacob
authors.initials: AJ
authors.lastname: Purty
authors.affiliation: Assistant Professor, Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India.
authors.forename: Ramesh Chand
authors.initials: RC
authors.lastname: Chauhan
authors.forename: Murugan
authors.initials: M
authors.lastname: Natesan
authors.forename: Johnson
authors.initials: J
authors.lastname: Cherian
authors.forename: Zile
authors.initials: Z
authors.lastname: Singh
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Sharma
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D006801:Humans; D007194:India; D011446:Prospective Studies; D012189:Retrospective Studies; D061665:Time-to-Treatment; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy