Factors Affecting the Early Diagnosis of Smear-positive Pulmonary Tuberculosis in Patients in Qom Province, Iran

Abstract

Background and Objectives: According to the report of the World Health Organization (WHO), almost one-third of the world’s population is infected with tuberculosis (TB). The delay in TB diagnosis, in addition to increasing mortality, can increase the duration of disease transmission. This study aims to identify the factors affecting the early detection of smear-positive pulmonary TB in Patients in Qom Province, Iran. Methods: In this case-control study, 120 patients with smear-positive pulmonary TB (60 with a diagnosis delayed for more than three months and 60 with a timely diagnosis) diagnosed from 2018 to 2021 in Qom Province participated. To determine the factors effective in early diagnosis of pulmonary TB, the odds ratio of each factor was calculated, and logistic regression analysis was used for data analysis. Results: The prescription of the sputum test at the first visit had the most significant effect on the early diagnosis of pulmonary TB (odds ratio=161, P<0.001). The TB in patients who visited the clinics and those visited by general practitioners was diagnosed with a higher delay. The lack of knowledge of existing TB diagnosis and treatment services in health centers had increased the diagnosis delay by 2.3. Occupation, gender, and place of residence were not found to be effective factors. Conclusion: It seems that most doctors in Iran neglect to prescribe a sputum test for patients suspected of pulmonary TB and only prescribe chest x-rays. Training and informing doctors, private medical centers, and pharmacies in referring patients suspected of pulmonary TB to the health centers where the patients live can cause timely diagnosis of pulmonary TB.