DELAY IN THE DIAGNOSIS AND TREATMENT OF PULMONARY TUBERCULOSIS IN PATIENTS ATTENDING A UNIVERSITY TEACHING HOSPITAL

SETTING: University Hospital, Kuala Lumpur, Malaysia. OBJECTIVE: To in vestigate patient and doctor delays in the diagnosis and treatment of pulmonary tuberculosis in patients attending a tertiary teaching hospi tal. DESIGN: A total of 97 patients with newly diagnosed pulmonary tub erculosis at our hospital were interviewed to study the process of cas e-finding since the onset of symptoms. Time intervals between onset, f irst medical consultation and the final diagnosis and commencement of antituberculosis treatment were determined. Demographic and clinical f eatures were evaluated for their effect on these intervals. RESULTS: 3 6 cases were sputum smear-positive and 61 were smear-negative. Tubercu losis was eventually confirmed in 32 of the smear-negative cases. The medians of patient delay, doctor delay and total delay were 2 weeks, 7 weeks and 12.5 weeks, respectively. The majority of the patients cons ulted private general practitioners but the diagnosis of tuberculosis was rarely suspected; chest X-ray and sputum examinations were under-u tilized. CONCLUSION: To shorten patient delay the public should be edu cated about the symptoms of tuberculosis and the importance of early m edical consultation. Private general practitioners should be more aler t to the diagnostic possibility of tuberculosis and refer the patients promptly to the government hospitals for appropriate investigation.