Monitoring delays in diagnosis of pulmonary tuberculosis in eight cities in Colombia
ABSTRACT Objective To measure time between onset of tuberculosis (TB) symptoms and start of treatment, and to identify factors associated with delay in eight Colombian cities. Methods Operational research with a retrospective analytical cohort design was conducted in 2014 using routinely collected d...
Main Authors: | , , , , , , |
---|---|
Format: | Article in Journal/Newspaper |
Language: | English Spanish Portuguese |
Published: |
Pan American Health Organization
|
Subjects: | |
Online Access: | https://doaj.org/article/82692af99d544dbb859f7a07e60f0c0e |
id |
ftdoajarticles:oai:doaj.org/article:82692af99d544dbb859f7a07e60f0c0e |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:82692af99d544dbb859f7a07e60f0c0e 2023-05-15T15:16:04+02:00 Monitoring delays in diagnosis of pulmonary tuberculosis in eight cities in Colombia David A. Rodríguez Kristien Verdonck Karen Bissell Juan José Victoria Mohammed Khogali Diana Marín Ernesto Moreno https://doaj.org/article/82692af99d544dbb859f7a07e60f0c0e EN ES PT eng spa por Pan American Health Organization http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892016000100012&lng=en&tlng=en https://doaj.org/toc/1680-5348 1680-5348 https://doaj.org/article/82692af99d544dbb859f7a07e60f0c0e Revista Panamericana de Salud Pública, Vol 39, Iss 1, Pp 12-18 Tuberculosis tuberculosis pulmonar monitoreo monitoreo epidemiológico agentes comunitarios de salud población urbana diagnóstico tardío investigación operativa Colombia Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article ftdoajarticles 2022-12-31T14:08:40Z ABSTRACT Objective To measure time between onset of tuberculosis (TB) symptoms and start of treatment, and to identify factors associated with delay in eight Colombian cities. Methods Operational research with a retrospective analytical cohort design was conducted in 2014 using routinely collected data about new smear-positive pulmonary TB patients from eight cities in Colombia (Barranquilla, Bogotá, Bucaramanga, Cali, Cúcuta, Medellín, Pereira, and Villavicencio). Date of symptom onset was sourced from TB surveillance databases. Data on all other variables came from National TB Program (NTP) registers. Results There were 2 545 new cases of smear-positive pulmonary TB, but a plausible date of symptom onset was available for only 1 456 (57%). Median number of days between symptom onset and treatment start was 51 days (interquartile range: 27–101). A total of 72% of patients had a delay (> 30 days between symptom onset and treatment start), and 28% had a 3+ bacillary load at diagnosis. Based on multiple logistic regression, three factors were significantly associated with delay: being uninsured (odds ratio (OR): 1.30; 95% confidence interval (CI): 1.01–1.68) and having an unknown HIV status (OR: 1.81; CI: 1.04–3.17), which increased risk, and coming from a neighborhood with NTP-employed community health workers, which decreased risk (OR: 0.56; CI: 0.34–0.90). Conclusions Delays still prevent timely TB diagnosis and treatment in Colombia. As the country aims for TB elimination, delays must be reduced, especially in cities and vulnerable neighborhoods, to stop community transmission. The NTP should focus not only on the number of cases detected but also on how long it takes to detect them. To monitor interventions designed to reduce delays, additional dates in the process should be recorded routinely. In addition, reliability and completeness of data are crucial for monitoring. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English Spanish Portuguese |
topic |
Tuberculosis tuberculosis pulmonar monitoreo monitoreo epidemiológico agentes comunitarios de salud población urbana diagnóstico tardío investigación operativa Colombia Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Tuberculosis tuberculosis pulmonar monitoreo monitoreo epidemiológico agentes comunitarios de salud población urbana diagnóstico tardío investigación operativa Colombia Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 David A. Rodríguez Kristien Verdonck Karen Bissell Juan José Victoria Mohammed Khogali Diana Marín Ernesto Moreno Monitoring delays in diagnosis of pulmonary tuberculosis in eight cities in Colombia |
topic_facet |
Tuberculosis tuberculosis pulmonar monitoreo monitoreo epidemiológico agentes comunitarios de salud población urbana diagnóstico tardío investigación operativa Colombia Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
ABSTRACT Objective To measure time between onset of tuberculosis (TB) symptoms and start of treatment, and to identify factors associated with delay in eight Colombian cities. Methods Operational research with a retrospective analytical cohort design was conducted in 2014 using routinely collected data about new smear-positive pulmonary TB patients from eight cities in Colombia (Barranquilla, Bogotá, Bucaramanga, Cali, Cúcuta, Medellín, Pereira, and Villavicencio). Date of symptom onset was sourced from TB surveillance databases. Data on all other variables came from National TB Program (NTP) registers. Results There were 2 545 new cases of smear-positive pulmonary TB, but a plausible date of symptom onset was available for only 1 456 (57%). Median number of days between symptom onset and treatment start was 51 days (interquartile range: 27–101). A total of 72% of patients had a delay (> 30 days between symptom onset and treatment start), and 28% had a 3+ bacillary load at diagnosis. Based on multiple logistic regression, three factors were significantly associated with delay: being uninsured (odds ratio (OR): 1.30; 95% confidence interval (CI): 1.01–1.68) and having an unknown HIV status (OR: 1.81; CI: 1.04–3.17), which increased risk, and coming from a neighborhood with NTP-employed community health workers, which decreased risk (OR: 0.56; CI: 0.34–0.90). Conclusions Delays still prevent timely TB diagnosis and treatment in Colombia. As the country aims for TB elimination, delays must be reduced, especially in cities and vulnerable neighborhoods, to stop community transmission. The NTP should focus not only on the number of cases detected but also on how long it takes to detect them. To monitor interventions designed to reduce delays, additional dates in the process should be recorded routinely. In addition, reliability and completeness of data are crucial for monitoring. |
format |
Article in Journal/Newspaper |
author |
David A. Rodríguez Kristien Verdonck Karen Bissell Juan José Victoria Mohammed Khogali Diana Marín Ernesto Moreno |
author_facet |
David A. Rodríguez Kristien Verdonck Karen Bissell Juan José Victoria Mohammed Khogali Diana Marín Ernesto Moreno |
author_sort |
David A. Rodríguez |
title |
Monitoring delays in diagnosis of pulmonary tuberculosis in eight cities in Colombia |
title_short |
Monitoring delays in diagnosis of pulmonary tuberculosis in eight cities in Colombia |
title_full |
Monitoring delays in diagnosis of pulmonary tuberculosis in eight cities in Colombia |
title_fullStr |
Monitoring delays in diagnosis of pulmonary tuberculosis in eight cities in Colombia |
title_full_unstemmed |
Monitoring delays in diagnosis of pulmonary tuberculosis in eight cities in Colombia |
title_sort |
monitoring delays in diagnosis of pulmonary tuberculosis in eight cities in colombia |
publisher |
Pan American Health Organization |
url |
https://doaj.org/article/82692af99d544dbb859f7a07e60f0c0e |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista Panamericana de Salud Pública, Vol 39, Iss 1, Pp 12-18 |
op_relation |
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892016000100012&lng=en&tlng=en https://doaj.org/toc/1680-5348 1680-5348 https://doaj.org/article/82692af99d544dbb859f7a07e60f0c0e |
_version_ |
1766346383171780608 |