Research code: 568
Ethics code: IR.MUQ.REC.1398.129
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Karami Joushin M, Mohebi S, Saghfipour A, Mohammadi M, Ghafuri Y, Zareh B. Factors Affecting the Early Diagnosis of Smear-positive Pulmonary Tuberculosis in Patients in Qom Province, Iran. Qom Univ Med Sci J 2023; 17 : 2042.1
URL: http://journal.muq.ac.ir/article-1-3724-en.html
URL: http://journal.muq.ac.ir/article-1-3724-en.html
Moharram Karami Joushin1 
, Siamak Mohebi2 , Abedin Saghfipour * 3, Mahdi Mohammadi1 , Yadollah Ghafuri4 , Bahareh Zareh1
, Siamak Mohebi2 , Abedin Saghfipour * 3, Mahdi Mohammadi1 , Yadollah Ghafuri4 , Bahareh Zareh1
1- Department of Prevention and Fight Against Diseases, Health Deputy, Qom University of Medical Sciences, Qom, Iran.
2- Department of Health Education and Health Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran.
3- Department of Public Health, School of Health, Qom University of Medical Sciences, Qom, Iran.
4- Department of Environment Health, School of Health, Qom University of Medical Sciences, Qom, Iran.
2- Department of Health Education and Health Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran.
3- Department of Public Health, School of Health, Qom University of Medical Sciences, Qom, Iran.
4- Department of Environment Health, School of Health, Qom University of Medical Sciences, Qom, Iran.
Abstract: (391 Views)
Background and Objectives: According to the report of the World Health Organization (WHO), almost one-third of the world’s population is infected with tuberculosis (TB). The delay in TB diagnosis, in addition to increasing mortality, can increase the duration of disease transmission. This study aims to identify the factors affecting the early detection of smear-positive pulmonary TB in Patients in Qom Province, Iran.
Methods: In this case-control study, 120 patients with smear-positive pulmonary TB (60 with a diagnosis delayed for more than three months and 60 with a timely diagnosis) diagnosed from 2018 to 2021 in Qom Province participated. To determine the factors effective in early diagnosis of pulmonary TB, the odds ratio of each factor was calculated, and logistic regression analysis was used for data analysis.
Results: The prescription of the sputum test at the first visit had the most significant effect on the early diagnosis of pulmonary TB (odds ratio=161, P<0.001). The TB in patients who visited the clinics and those visited by general practitioners was diagnosed with a higher delay. The lack of knowledge of existing TB diagnosis and treatment services in health centers had increased the diagnosis delay by 2.3. Occupation, gender, and place of residence were not found to be effective factors.
Conclusion: It seems that most doctors in Iran neglect to prescribe a sputum test for patients suspected of pulmonary TB and only prescribe chest x-rays. Training and informing doctors, private medical centers, and pharmacies in referring patients suspected of pulmonary TB to the health centers where the patients live can cause timely diagnosis of pulmonary TB.
Methods: In this case-control study, 120 patients with smear-positive pulmonary TB (60 with a diagnosis delayed for more than three months and 60 with a timely diagnosis) diagnosed from 2018 to 2021 in Qom Province participated. To determine the factors effective in early diagnosis of pulmonary TB, the odds ratio of each factor was calculated, and logistic regression analysis was used for data analysis.
Results: The prescription of the sputum test at the first visit had the most significant effect on the early diagnosis of pulmonary TB (odds ratio=161, P<0.001). The TB in patients who visited the clinics and those visited by general practitioners was diagnosed with a higher delay. The lack of knowledge of existing TB diagnosis and treatment services in health centers had increased the diagnosis delay by 2.3. Occupation, gender, and place of residence were not found to be effective factors.
Conclusion: It seems that most doctors in Iran neglect to prescribe a sputum test for patients suspected of pulmonary TB and only prescribe chest x-rays. Training and informing doctors, private medical centers, and pharmacies in referring patients suspected of pulmonary TB to the health centers where the patients live can cause timely diagnosis of pulmonary TB.
Article number: 2042.1
Type of Study: Original Article |
Subject:
بهداشت عمومی
Received: 2023/04/24 | Accepted: 2023/08/5 | Published: 2023/08/1
Received: 2023/04/24 | Accepted: 2023/08/5 | Published: 2023/08/1
References
1. Kumar V, Abbas AK, Fausto N, Mitchell R. Robbins basic pathology. Edinburgh: Elsevier Health Sciences; 2007. [Link]
2. Jensen PA, Lambert LA, Iademarco MF, Ridzon R; CDC. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep. 2005; 54(RR-17):1-141. [PMID]
3. Khazaei S, Zahiri A, Hasanbeigi A, Mohammadian-Hafshejani A, Salehiniya H, Saatchi M, et al. [Effect of intensity of sputum smear positive in pulmonary tuberculosis patients at the beginning of treatment on treatment outcome (Persian)]. J Ilam Univ Med Sci. 2016; 24(1):1-7. [Link] [DOI:10.18869/acadpub.sjimu.24.1.1]
4. Buregyeya E, Criel B, Nuwaha F, Colebunders R. Delays in diagnosis and treatment of pulmonary tuberculosis in Wakiso and Mukono districts, Uganda. BMC Public Health. 2014; 14:586. [DOI:10.1186/1471-2458-14-586] [PMID] [DOI:10.1186/1471-2458-14-586]
5. Golub JE, Bur S, Cronin WA, Gange S, Baruch N, Comstock GW, et al. Patient and health care system delays in pulmonary tuberculosis diagnosis in a low-incidence state. Int J Tuberc Lung Dis. 2005; 9(9):992. [Link]
6. Habibzade S, Ghobadi H, Poorfarzi F, Barak M, Hazrati S, Moeini Jozei A, et al. [Factors associated with delay in diagnosis of tuberculosis in Ardabil province (Persian)]. Iran J Infect Dis Trop Med. 2014; 17(59):17-21. [Link]
7. Shahriyar M, Niazi A, Karimian R, Naroii E, Pishjoo M, Nikoseresht M, et al. [Causes of delay in diagnosis of smear-positive pulmonary tuberculosis patients referred to the tuberculosis center of Zahedan (Persian)]. Zahedan J Res Med Sci. 2012; 14(8):29-32 [Link]
8. Zerbini E, Chirico MC, Salvadores B, Amigot B, Estrada S, Algorry G. Delay in tuberculosis diagnosis and treatment in four proviences of Argentina. Int J Tuberc Lung Dis. 2008; 12(1):63-8. [Link]
9. Malbasa M, Pesut D. Is there delay in diagnosis of pulmonary tuberculosis in an intermediate-to-low TB incidence setting. Pneumologia. 2011; 60(3):138-42. [PMID]
10. Demissie M, Lindtjorn B, Berhane Y. Patient and health service delay in the diagnosis of pulmonary tuberculosis in Ethiopia. BMC Public Health. 200; 2:23. [DOI:10.1186/1471-2458-2-23] [PMID] [DOI:10.1186/1471-2458-2-23]
11. Rezai Talab F, Akbari H, Rezaeetalab GH. [Delay in diagnosis patient with pulmonary tuberculosis (Persian)]. Med J Mashhad Univ Med Sci. 2009; 99:37-40. [Link]
12. Mirsaeidi SM, Tabarsi P, Mohajer K, Falah-Tafti S, Jammati HR, Farnia P, et al. A long delay from the first symptom to definite diagnosis of pulmonary tuberculosis. Arch Iranian Med. 2007; 10(2):190-3. [Link]
13. Nasehi M, Mohammad K, Gouya MM, Madjdzadeh SR, Zamani G, Holakoii K, et al. Health care system delay in diagnosis and treatment of contagious tuberculosis in I.R.IRAN - 2003. Tanaffos. 2003; 2(4):55-64. [Link]
14. Leutscher P, Madsen G, Erlandsen M, Veirum J, Ladefoged K, Thomsen V, et al. Demographic and clinical characteristics in relation to patient and health system delays in a tuberculosis low-incidence country. Scand J Infect Dis. 2012; 44(1):29-36. [DOI:10.3109/00365548.2011.608081] [PMID] [DOI:10.3109/00365548.2011.608081]
15. Bassili A, Seita A, Baghdadi S, AlAbsi A, Abdilai I, Agboatwalla M, et al. Diagnostic and treatment delay in tuberculosis in 7 countries of the Eastern Mediterranean region. Infect Dis Clin Pract. 2008; 16(1):23-35. [DOI:10.1097/IPC.0b013c31815d8d61] [DOI:10.1097/IPC.0b013c31815d8d61]
16. Khazaei S, Roshanaei G, Kousehlou Z, Zahiri A, Mohammadian-Hafshejani A, Salehiniya H. [Assessment of related factors on delay in diagnosis of patients with smear-positive pulmonary tuberculosis (Persian)]. J Isfahan Med Sch. 2015; 33(332):596-603. [Link]
17. Yari M, Soheylizad M, Valipour A, Eftekhari A, Khazaei S, Gholamaliee B. [The factors leading to delayed diagnosis of tuberculosis in Abadan during 2010-2013 (Persian)]. Nafas J. 2016; 3(2):27-33. [Link]
18. Rabin AS, Kuchukhidze G, Sanikidze E, Kempker RR, Blumberg HM. Prescribed and self-medication use increase delays in diagnosis of tuberculosis in the country of Georgia. Int J Tuberc Lung Dis. 2013; 17(2):214-20. [DOI:10.5588/ijtld.12.0395] [PMID] [DOI:10.5588/ijtld.12.0395]
19. Jiang Y, Luo L, Gui M, Liu L, Lin Y, Deng G, et al. Duration and determinants of delayed diagnosis with tuberculosis in Shenzhen, China: A cross-sectional study. Risk Manag Healthc Policy. 2022; 15:1473-81. [DOI:10.2147/RMHP.S367998] [PMID] [DOI:10.2147/RMHP.S367998]
20. Ayalew YE, Yehualashet FA, Bogale WA, Gobeza MB. Delay for tuberculosis treatment and its predictors among adult tuberculosis patients at debremarkos town public health facilities, North West Ethiopia. Tuberc Res Treat. 2020; 2020:1901890. [DOI:10.1155/2020/1901890] [PMID] [DOI:10.1155/2020/1901890]
21. Getnet F, Demissie M, Assefa N, Mengistie B, Worku A. Delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: Systematic review and meta-analysis. BMC Pulm Med. 2017; 17(1):202. [DOI:10.1186/s12890-017-0551-y] [PMID] [DOI:10.1186/s12890-017-0551-y]
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Owned by Qom University of Medical Sciences
Published by Qom University of Medical Sciences Press
eISSN: 2008-1375
pISSN: 1735-7799
Email: journal[at]muq.ac.ir
j.mua.ac[at]gmail.com
