Socio-economic, gender and health services factors affecting diagnostic delay for tuberculosis patients in urban Zambia

In-depth interviews regarding health seeking behaviour were conducted with 202 adults registered with pulmonary tuberculosis at the centralized Chest Clinic in Lusaka, Zambia. The median (mean) diagnostic delay was 8.6 (9) we eks, and was significantly associated with the following factors: female se x, lower education, more than six instances of health-seeking encounters, o utpatient diagnosis of tuberculosis, and visiting a private doctor or tradi tional healer. More effective tuberculosis control interventions require no vel methods of accessing women and less educated people. Decentralization o f public tuberculosis care and improved integration with private sector hea lth providers may also reduce diagnostic delay.