Author:
Moniz Marta,Soares Patrícia,Leite Andreia,Nunes Carla
Abstract
Abstract
Background
Delay in Tuberculosis (TB) diagnosis affects foreign-born and nationals in different ways, especially in low-incidence countries. This study characterises total delay and its components amongst foreign-born individuals in Portugal. Additionally, we identify risk factors for each type of delay and compare their effects between foreign-born and nationals.
Methods
We analysed data from the Portuguese TB surveillance system and included individuals with pulmonary TB (PTB), notified between 2008 and 2017. We described patient, healthcare, and total delays. Cox regression was used to identify factors associated with each type of delay. All analyses were stratified according to the origin country: nationals (those born in Portugal) and foreign-born.
Results
Compared with nationals, foreign-born persons presented statistically significant and longer median total and patient delays (Total: 67 vs. 63; Patient: 44 vs. 36 days), and lower healthcare services delays (7 vs. 9 days). Risk factors for delayed diagnosis differed between foreign-born and nationals. Being unemployed, having drug addiction, and having comorbidities were identified as risk factors for delayed diagnosis in national individuals but not in foreigners. Alcohol addiction was the only factor identified for healthcare delay for both populations: foreign-born (Hazard Ratio 1.34 [95% confidence interval 1.17;1.53]); nationals (Hazard Ratio 1.20 [95% confidence interval 1.13;1.27]).
Conclusions
Foreign-born individuals with PTB take longer to seek health care. While no specific risk factors were identified, more in-depth studies are required to identify barriers and support public health intervention to address PTB diagnosis delay in foreign-born individuals.
Funder
Fundação para a Ciência e a Tecnologia
Publisher
Springer Science and Business Media LLC
Reference39 articles.
1. World Health Organization (WHO). Global tuberculosis report 2019. Geneva: World Health Organization (WHO); 2019.
2. European Centre for Disease Prevention and Control (ECDC). Tuberculosis surveillance and monitoring in Europe 2019: 2017 data. Copenhagen: Regional Office for Europe. World Health Organization; 2019. 164 p.
3. Storla DG, Yimer S, Bjune GA. A systematic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health. 2008;8(15):9.
4. Sreeramareddy CT, Panduru KV, Menten J, Van den Ende J. Time delays in diagnosis of pulmonary tuberculosis: a systematic review of literature. BMC Infect Dis. 2009;9:10.
5. Nunes C, Taylor BM. Modelling the time to detection of urban tuberculosis in two big cities in Portugal: a spatial survival analysis. Int J Tuberc Lung Dis. 2016;20(9):1219–25.
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献