title: Delays in tuberculosis suspicion and diagnosis and related factors.
abstract: OBJECTIVE
  To measure the delays in tuberculosis (TB) suspicion and diagnosis and to identify factors related.
  
  
  METHODS
  We defined the delay in TB suspicion as the time between the perception of the symptoms by the patient and the search for health-care service and the diagnosis, as the time between the first visit to the health-care service and the diagnosis. We interviewed 100 patients treated at the health services in São José do Rio Preto that were diagnosed and reported/notified in 2008 and 2009, and the delays were quantified. We obtained the possible explanatory variables from interviews and secondary information available in the surveillance system. The addresses of TB patients and health-care services were geocoded. Variables were assessed by multiple linear regression analysis and, when spatial dependency was detected, by spatial regression.
  
  
  RESULTS
  The median values for the delays in TB suspicion and diagnosis were both 15 days. The first was modeled by linear regression and a positive relationship was found with the distances covered by the patients in order to get primary health-care service. The last was modeled by spatial regression and a positive relationship was found with the age and the frequency with the patients sought health-care services and a negative relationship with the pulmonary clinical form.
  
  
  CONCLUSIONS
  The study revealed the existence of gaps in TB control activities related to the patients and the organization of the health-care services and showed the importance of taking into account the spatial dependence of the phenomena analyzed.
authors.affiliation: União das Faculdades dos Grandes Lagos, São José do Rio Preto, SP, Brasil.
authors.forename: Natália Sperli Geraldes Marin dos Santos
authors.initials: NS
authors.lastname: Sasaki
authors.affiliation: Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.
authors.forename: Maria de Lourdes Sperli Geraldes dos
authors.initials: Mde L
authors.lastname: Santos
authors.affiliation: Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.
authors.forename: Silvia Helena F
authors.initials: SH
authors.lastname: Vendramini
authors.affiliation: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruffino-Netto
authors.affiliation: Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Teresa Cristina Scatena
authors.initials: TC
authors.lastname: Villa
authors.affiliation: Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Francisco
authors.initials: F
authors.lastname: Chiaravalloti-Neto
mesh_terms: D006297:Health Services Accessibility; D006801:Humans; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis*