Delay in the diagnosis of tuberculosis in NepalReport as inadecuate

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BMC Public Health

, 9:236

First Online: 14 July 2009Received: 22 October 2008Accepted: 14 July 2009DOI: 10.1186-1471-2458-9-236

Cite this article as: Basnet, R., Hinderaker, S.G., Enarson, D. et al. BMC Public Health 2009 9: 236. doi:10.1186-1471-2458-9-236


BackgroundIdentifying reasons for delay in diagnosis and treatment of tuberculosis is important for the health system to find ways to treat patients as early as possible, and hence reduce the suffering of patients and transmission of the disease. The objectives of this study was to assess the duration of delay in the diagnosis of tuberculosis and to investigate its determinants.

MethodsA cross-sectional survey was conducted using a structured questionnaire in 307 new tuberculosis patients registered by the National Tuberculosis Programme NTP in all DOTS centres in Banke district of Nepal.

ResultsThe median patient delay was 50 days, the median health system delay was 18 days, and the median total delay was 60 days. Sputum smear negative participants had significantly lower risk of patient delay. Smokers using >5 cigarettes per day had higher risk of patient delay and health system delay.

ConclusionTotal delay in the diagnosis of tuberculosis in Banke district is shorter compared to other places in Nepal and neighbouring countries. The shorter delay for smear negative pulmonary tuberculosis raises suspicion that many of these patients are not examined according to the NTP manual before being diagnosed. Increasing public awareness of the disease and expansion of the facilities with assured quality could be helpful to reduce the delay in the diagnosis of tuberculosis.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-9-236 contains supplementary material, which is available to authorized users.

Rajendra Basnet, Sven Gudmund Hinderaker contributed equally to this work.

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Author: Rajendra Basnet - Sven Gudmund Hinderaker - Don Enarson - Pushpa Malla - Odd Mørkve


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