Open Access Short Report

Delay in diagnosis of tuberculosis in Rawalpindi, Pakistan

Muhammad AN Saqib1, Irum N Awan1, Syed KA Rizvi1, Mirza I Shahzad1, Zahid S Mirza2, Sabira Tahseen3, Imran H Khan4 and Azra Khanum1*

Author Affiliations

1 Department of Biochemistry, Pir Mehr Ali Shah Arid Agriculture University Rawalpindi, Murree Road, Rawalpindi-46300, Pakistan

2 Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University Rawalpindi, Murree Road, Rawalpindi-46300, Pakistan

3 National Tuberculosis Control Program, Islamabad-44000, Pakistan

4 Center for Comparative Medicine, University of California, Davis CA-95616, USA

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BMC Research Notes 2011, 4:165  doi:10.1186/1756-0500-4-165

Published: 26 May 2011

Abstract

Background

Delay in diagnosis and treatment of tuberculosis (TB) may enhance the chances of morbidity and mortality and play a key role in continuous transmission of the bacilli. The objective of this study was to describe health care seeking behavior of suspected TB patients and initial diagnostic work up prior to consultation and diagnosis at National TB Center (NTC).

Findings

Interviews of 252 sputum smear positive patients were taken from NTC, Rawalpindi. The duration between on-set of symptoms and start of treatment was considered as the total delay and correlated with general characteristics of TB patients. The proportion of males and females were 49.6% and 50.4% with median age of 25 and 24 years respectively. A median delay of 56 days (8 weeks) was observed which was significantly associated with age, cough and fever. More than 50% of the current patients had a history of contact with previously diagnosed TB patients. The majority of patients (63%) visited health care providers within three weeks of appearance of symptoms but only thirty five percent were investigated for TB diagnosis.

Conclusion

Cough and fever are being ignored as likely symptoms of TB by patients as well as health care providers resulting in delay. Engaging private practitioners through public private mix (PPM) approach for expansion of TB diagnosis and increasing public awareness could be more beneficial to reduce delay.