The Delay in Diagnosis of Tuberculosis in the Monteregie region of Quebec, Canada

Abstract

Despite being more prevalent in developing countries, tuberculosis (TB) remains an important health problem in Canada. Long diagnosis delays of respiratory tuberculosis are associated with adverse consequences for the patient but also for the community. From a public health perspective, identification of factors associated with long delays of diagnosis could help reduce these delays. 1)To describe diagnosis delays of respiratory tuberculosis in Monteregie 2)To identify the characteristics of patients and factors associated with longer diagnosis delays 3)To identify consequences of these delays. The study is descriptive and transversal. Data were obtained from notifiable diseases files of the Public Health Department of the Health and Social Services Agency of Monteregie. The diagnosis delay was calculated using the first symptomatic date and the date of diagnosis. For continued variable analyses, Student t tests and an ANOVA test were done. For categorical variables, Pearson's chi squared test and a Mann-Whitney test were done. The average delay of diagnosis for the 115 cases studied was 92.2 days (CI 80.6-103.8). Weight loss and/or non specific general malaise were associated with a longer diagnosis delay. No association was found between the diagnosis delay and possible consequences of longer delays. Most patients had a diagnosis delay longer than two months. A larger study that would divide the total diagnosis delay into a patient delay and a suspicion delay (health care system delay) could permit a better identification of factors that favour long delays.