Delays in the diagnosis and treatment of hospitalized patients with smear-positive pulmonary tuberculosis

The aim of present study was to investigate whether there was any delay in the diagnosis and treatment of inpatients with smear-positive pulmonary tub erculosis followed-up in our centre. We reviewed clinical records in Februa ry 1999 and identified 134 hospitalized patients with smear-positive pulmon ary tuberculosis. Clinical files of the patients were analysed and a questi onnaire was completed. Several intervals and delays were calculated. Median application interval was 17.5 days [95% confidence interval (CI) 21.3-32.4 days], median referral interval was 3-5 days (95% CI 6.8-11.4 days), media n diagnosis interval was 3 days (95% CI 3.3-4.5 days) and median initiation of treatment interval was 1 day (95% CI 1.1-1.6 days). Patients delay was present in 28.4% of cases. The referral interval was longer than 2 days in 82 patients (institutional delay). Ninety-three patients (69.4%) had delays in the diagnosis and 34 patients (25.4%) had delays in the treatment. Ther e was a doctor's delay in 119 of 134 patients (88.8%) and clinic's delay in 98 patients (73.2%). Our results have suggested that hospitalized patients with smear-positive pulmonary tuberculosis experience several delays. Thes e delays may result in increased risk for transmission of infection. Decrea se in the risk of infection for community and medical personal may only be obtained by preventing these delays. (C) 2001 Harcourt Publishers Ltd.