Facteurs De Retard Diagnostique De La Tuberculose Pulmonaire Vus À l’Unité De Soins, De Formation Et De Recherche De Pneumologie Befelatanana

Abstract

Delay in diagnosis is significant to tuberculosis prognosis. The aim of this study is to evaluate the diagnosis delay of tuberculosis and to identify determinants of “patient delay”, “health system delay”, and “total delay” in the diagnosis of tuberculosis. It is a prospective study of the patients who were hospitalized at the Unité de Soins de Formation et de Recherche (USFR) of Pneumology in Befelatanana, Antananarivo Madagascar, during the period of 1 st October 2014 to 30 April 2015 (7 months). We included all patients with diagnosis of pulmonary tuberculosis. Sixty six patients were also included. The mean time of patient delay, health system delay, and total delay were 26,30± 36,87, 69,56±64, and 96,35±72,65 days respectively. The different variables that affected diagnosis delay were: tobacco smoke (OR : 3,6723), asthenia (OR : 5,4815), anorexia (OR : 2,9524), and hemoptysis (OR : 0,2406) for the total delay. Knowledge about tuberculosis signs (OR : 0,164) and transmissions (OR : 0,243) was for the patient delay. Hemoptysis (OR : 8,1250), asthenia (OR : 0,1081), breathlessness (OR : 0,3556), infiltrative syndrome (OR : 0,2500), and alveolar syndrome (OR : 0,0687) in chest Xray was for the health system delay. Having an understanding of these factors of tuberculosis diagnosis delay will result to a decrease in the diagnosis delay.