Storla et al identified risk factors for a delay in diagnosis of tuberculosis. The authors are from the University of Oslo and Ulleval University Hospital in Oslo, Norway.
Risk factors associated with a delay in diagnosis:
(1) HIV infection
(2) presence of chronic cough and/or other lung disease
(3) negative sputum smear
(4) extrapulmonary tuberculosis
(5) rural residence
(6) low access to healthcare
(7) initial visit to low-level healthcare facility, private practitioner or traditional healer
(8) repeated consultations at the same level (vs referral to a specialist)
(9) old age
(10) female sex
(11) substance and/or alcohol abuse
(12) immigrant
(13) low educational level
(14) lack of awareness about tuberculosis in patient or clinician
(15) self-treatment
(16) stigma
(17) incomprehensive beliefs about tuberculosis
(18) no insurance
(19) absence of hemoptysis or significant symptoms
(20) generally poor health
(21) poverty
The authors found that initiation of therapy was within a reasonable period of time once the diagnosis was made.
