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Volume 8, Issue 9 (Suppl)
J AIDS Clin Res
ISSN: 2155-6113 JAR, an open access journal
STD Asia Pacific 2017
October 23-25, 2017
OCTOBER 23-25, 2017 OSAKA, JAPAN
7
TH
ASIA PACIFIC
STD and Infectious Diseases Congress
Delay in diagnosis of pulmonary tuberculosis in low and middle-income settings: Systematic review
and meta-analysis
Fentabil Getnet Yimer, Yemane Berhane, Nega Assefa, Bizatu Mengistie and Alemayehu Worku
Addis Ababa University, Ethiopia
A
ssessment of time delays in diagnosis of tuberculosis is essential to evaluate effectiveness of control programs and identify
programmatic impediments. We have reviewed recent studies to summarize patient, health system and total delays in
diagnosis of pulmonary tuberculosis in low- andmiddle- income countries.The reviewwas done following standard procedures
of the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement and checklist. Web-based
databases were searched to retrieve relevant studies from 2007 to 2015 including Springer link, PubMed, Hinari and Google
scholar. Searching terms were pulmonary tuberculosis, diagnostic delay, patient delay, health system delay, provider delay,
doctor delay, health care seeking and health care seeking behavior. Retrieved studies were summarized by systematic review
and meta-analysis using comprehensive meta-analysis software. 40 studies involving 18,975 patients qualified for systematic
review and 14 of them for meta-analysis. The median total delay ranges from 30 to 366.5 days; with a relatively more for patient
delay (4 to 199 days) compared to health system delay (2 to 128.5 days). The key determinants of patient delay were poor
literacy, long distance to the nearest health facilities, evil/bad luck perception, poor knowledge, first care seeking from informal
providers, self-medication, pulmonary co-morbidity and mild severity of illness among others. Likewise, good functional
status, unusual symptoms, first care seeking at private/low level facilities, normal chest X-ray and smear negativity were key
determinants of health system delay. The meta-analysis showed 42% of pulmonary tuberculosis patients delayed seeking care by
a month or more; uneducated patients [pooled OR=1.5, 95% CI=1.1-1.9] and who sought initial care from informal providers
[pooled OR=3, 95% CI=2.3-3.9] had higher odds of patient delay. Delay in diagnosis is still a major challenge of tuberculosis
control and prevention programs in low and middle-income settings. Efforts to develop new strategies for better case-finding
and improving patients’ care seeking behavior need to be intensified.
b.infen4ever@gmail.comJ AIDS Clin Res 2017, 8:9 (Suppl)
DOI: 10.4172/2155-6113-C1-021