传染病与病理学杂志

抽象的

Delay in Diagnosis of Pulmonary Tuberculosis among Presumptive Tuberculosis Cases in Parts of Anambra State, Nigeria

Nwachukwu O Ndubuisi, Ogodo A Chibuike, Ulasi A Esther, and Okoronkwo U Christopher

Objectives/background: Pulmonary tuberculosis continues to increase due to late patient presentation for diagnosis at health facilities. The objectives of this study were to assess delay in diagnosis of pulmonary tuberculosis and identify reasons for the delay.

Methods: One thousand four hundred and eight seven presumptive tuberculosis cases participated in this cross-sectional study. Participants age ranged from 15 years and above; 661 (44.5%) were males and 826 (55.5%) were females. Diagnosis of pulmonary tuberculosis was based on National Tuberculosis Guidelines; using smear microscopy (ZN technique) and grading according to recent WHO policy where smears with>1 acid fast bacilli/100 high power fields was considered positive. Questionnaires were administered to patients to identify reasons for delay in diagnosing pulmonary tuberculosis.

Results: The main symptoms of pulmonary tuberculosis the patients presented with were cough (86%), fever (76%), night sweats (63.5%), weight loss (60.5%), and fatigue (56%). The prevalence of smear positive of pulmonary tuberculosis was 12.3%. Majority of presumptive TB cases 1,118 (75.2%) delayed diagnosis more 30 days following onset of symptoms. Only 369 (24.8%) presumptive tuberculosis cases sought diagnosis within 30 days of onset of symptoms. The longest patient delay was 186 days and minimum period of days before diagnosis was 14 days. The main reasons for delay in seeking early diagnosis were the fact that respondents thought the cause of pulmonary tuberculosis could not be diagnosed in a health facility (41.5%), poor knowledge of what pulmonary tuberculosis is (20.5%) and belief in the efficacy prayer house healing (13.6%).

Conclusion: There was a considerably long patient delay in diagnosing pulmonary tuberculosis. The reasons for the delay include ignorance and misconception on the part of the patients and their belief in the efficacy of prayer house healing. Reducing the delay will require health education on the importance of early diagnosis of pulmonary tuberculosis following onset of symptoms.