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conferenceseries
.com
Volume 5, Issue 6(Suppl)
J Infect Dis Ther, an open access journal
ISSN: 2332-0877
Euro Infectious Diseases 2017
September 07-09, 2017
September 07-09, 2017 | Paris, France
Infectious Diseases
6
th
Euro-Global Conference on
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
College of Medical and Health Sciences, Jigjiga University, Ethiopia
A
ssessment of time delays in diagnosis of tuberculosis is essential to evaluate effectiveness of control programs, and identify
programmatic impediments. Thus, we have reviewed recent studies to summarize patient, health system and total delays
in diagnosis of pulmonary tuberculosis and associated factors with it in low- and middle- income countries. The review was
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.Forty studies involving
18,975 patients qualified for systematic review and 14 of them for meta-analysis. The reported 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 as
cause, 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 and low level facilities,
normal chest X-ray and smear negative results 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 those who sought initial care from informal providers [pooled OR=3, 95%CI=2.3-3.9] had higher odds of patient
delay.
Conclusion:
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 Infect Dis Ther 2017, 5:6(Suppl)
DOI: 10.4172/2332-0877-C1-033