Imperial College London
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Professor Carlton A W Evans

Faculty of Medicine, Department of Infectious Disease

Professor of Global Health
 
 
 
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Contact

 

+44 (0)20 3313 3222carlton.evans Website

 
 
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Location

 

Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Bonadonna:2018:10.4269/ajtmh.17-0096,
author = {Bonadonna, L and Saunders, M and Guio, H and Zegarra, R and Evans, C},
doi = {10.4269/ajtmh.17-0096},
journal = {American Journal of Tropical Medicine and Hygiene},
pages = {1614--1623},
title = {Socioeconomic and behavioral factors associated with tuberculosis diagnostic delay in Lima, Peru},
url = {http://dx.doi.org/10.4269/ajtmh.17-0096},
volume = {98},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Early detection and diagnosis of tuberculosis (TB) is a global priority. Prolonged symptom duration prior to TB diagnosis is associated with increased morbidity, mortality and risk of transmission. We aimed to determine socioeconomic and behavioral factors associated with diagnostic delays among patients with TB. Data were collected from 105 patients with TB using a semi-structured interview guide in Lima, Peru. Factors associated with diagnostic delay were analyzed using negative binomial regression. The median delay from when symptoms commenced and the first positive diagnostic sample in public health facilities was 57 days (interquartile range (IQR): 28-126). In multivariable analysis, greater diagnostic delay was independently associated with patient older age; female sex; lower personal income prior to diagnosis; living with fewer people; and having more visits to professional health facilities prior to diagnosis (all p<0.05). Patients who first sought care at a private health facility had more visits overall to professional health facilities prior to diagnosis than those who first sought care from public or insured employee health facilities and had longer diagnostic delay in analysis adjusted for age and sex. Patients with TB were significantly more likely to first self-medicate than to visit professional health facilities prior to diagnosis (p=0.003). Thus, diagnostic delay was prolonged, greatest among older, low-income women and varied according to the type of care sought by individuals when their symptoms commenced. These findings suggest that TB case finding initiatives should target vulnerable groups in informal and private health facilities, where many patients with TB first seek healthcare.
AU  - Bonadonna,L
AU  - Saunders,M
AU  - Guio,H
AU  - Zegarra,R
AU  - Evans,C
DO  - 10.4269/ajtmh.17-0096
EP  - 1623
PY  - 2018///
SN  - 0002-9637
SP  - 1614
TI  - Socioeconomic and behavioral factors associated with tuberculosis diagnostic delay in Lima, Peru
T2  - American Journal of Tropical Medicine and Hygiene
UR  - http://dx.doi.org/10.4269/ajtmh.17-0096
UR  - http://hdl.handle.net/10044/1/57518
VL  - 98
ER  -
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