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Open Access Research article

Factors associated with delayed diagnosis of tuberculosis in hospitalized patients in a high TB and HIV burden setting: a cross-sectional study

Denise Rossato Silva*, Alice Mânica Müller and Paulo de Tarso Roth Dalcin

Author Affiliations

Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre. Rua Ramiro Barcelos, 2350 - Largo Eduardo Zaccaro Faraco - Bairro Santa Cecília -Porto Alegre, RS, 90.035-903, Brazil

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BMC Infectious Diseases 2012, 12:57  doi:10.1186/1471-2334-12-57

Published: 15 March 2012

Abstract

Background

The most essential components of TB control are early diagnosis and adequate treatment. Delay in the diagnosis and treatment of tuberculosis may result in more extensive disease and more complications, increase severity of the disease and is associated with higher risk of mortality. The purpose of this study was to identify factors associated with delayed diagnosis of TB in hospitalized patients.

Methods

We conducted a cross-sectional study in a general, tertiary care, university-affiliated hospital. Adult patients with TB that were hospitalized were identified retrospectively, and risk factors for delayed diagnosis were collected.

Results

The median delay until diagnosis was 6 days (IQR: 2-12 days). One hundred and sixty six (54.4%) patients were diagnosed ≤ 6 days, and 139 (45.6%) > 6 days after admission. The main factors associated with diagnostic delay (> 6 days) were extra-pulmonary TB and negative sputum smear.

Conclusions

Although hospitalization permits a rapid management of the patient and favors a faster diagnosis, we found an unacceptable time delay before the diagnosis of pulmonary TB was made. Future studies should focus on attempt to explain the reasons of diagnostic retard in the patients with the characteristics related to delay in this study.

Keywords:
Tuberculosism; Diagnostic delay; Treatment delay; Risk factors