Long Delays and Missed Opportunities in Diagnosing Smear-Positive Pulmonary Tuberculosis in Kampala, Uganda: A Cross-Sectional Study

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dc.contributor.authorSendagire, Ibrahim
dc.contributor.authorLoeff, Maarten Schim Van der
dc.contributor.authorMubiru, Mesach
dc.contributor.authorKonde-Lule, Joseph
dc.contributor.authorCobelens, Frank
dc.date.accessioned2023-04-19T17:19:29Z
dc.date.available2023-04-19T17:19:29Z
dc.date.issued2010
dc.description.abstractEarly detection and treatment of tuberculosis cases are the hallmark of successful tuberculosis control. We conducted a cross-sectional study at public primary health facilities in Kampala city, Uganda to quantify diagnostic delay among pulmonary tuberculosis (PTB) patients, assess associated factors, and describe trajectories of patients' health care seeking. Semi-structured interviews with new smear-positive PTB patients (≥15 years) registered for treatment. Between April 2007 and April 2008, 253 patients were studied. The median total delay was 8 weeks (IQR 4–12), median patient delay was 4 weeks (inter-quartile range [IQR] 1–8) and median health service delay was 4 weeks (IQR 2–8). Long total delay (>14 weeks) was observed for 61/253 (24.1%) of patients, long health service delay (>6 weeks) for 71/242 (29.3%) and long patient delay (>8 weeks) for 47/242 (19.4%). Patients who knew that TB was curable were less likely to have long total delay (adjusted Odds Ratio [aOR] 0.28; 95%CI 0.11–0.73) and long patient delay (aOR 0.36; 95%CI 0.13–0.97). Being female (aOR 1.98; 95%CI 1.06–3.71), staying for more than 5 years at current residence (aOR 2.24 95%CI 1.18–4.27) and having been tested for HIV before (aOR 3.72; 95%CI 1.42–9.75) was associated with long health service delay. Health service delay contributed 50% of the total delay. Ninety-one percent (231) of patients had visited one or more health care providers before they were diagnosed, for an average (median) of 4 visits (range 1–30). All but four patients had systemic symptoms by the time the diagnosis of TB was made. Diagnostic delay among tuberculosis patients in Kampala is common and long. This reflects patients waiting too long before seeking care and health services waiting until systemic symptoms are present before examining sputum smears; this results in missed opportunities for diagnosis.en_US
dc.identifier.citationSendagire, I., Schim Van der Loeff, M., Mubiru, M., Konde-Lule, J., & Cobelens, F. (2010). Long delays and missed opportunities in diagnosing smear-positive pulmonary tuberculosis in Kampala, Uganda: a cross-sectional study. PLOS one, 5(12), e14459.https://doi.org/10.1371/journal.pone.0014459en_US
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/8515
dc.language.isoenen_US
dc.publisherPLOS oneen_US
dc.subjectPulmonary Tuberculosisen_US
dc.subjectDiagnosingen_US
dc.subjectLong Delays and Missed Opportunitiesen_US
dc.titleLong Delays and Missed Opportunities in Diagnosing Smear-Positive Pulmonary Tuberculosis in Kampala, Uganda: A Cross-Sectional Studyen_US
dc.typeArticleen_US
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