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Factors associated with patient and provider delays for tuberculosis diagnosis and treatment in Asia: a systematic review and meta-analysis

PloS one, 2015-03, Vol.10 (3), p.e0120088-e0120088 [Peer Reviewed Journal]

COPYRIGHT 2015 Public Library of Science ;COPYRIGHT 2015 Public Library of Science ;2015 Cai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;2015 Cai et al 2015 Cai et al ;ISSN: 1932-6203 ;EISSN: 1932-6203 ;DOI: 10.1371/journal.pone.0120088 ;PMID: 25807385

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  • Title:
    Factors associated with patient and provider delays for tuberculosis diagnosis and treatment in Asia: a systematic review and meta-analysis
  • Author: Cai, Jing ; Wang, Xianhua ; Ma, Aiguo ; Wang, Qiuzhen ; Han, Xiuxia ; Li, Yong
  • Zhou, Dongsheng
  • Subjects: Analysis ; Asia ; Confidence intervals ; Consultation ; Control methods ; Cross-Sectional Studies ; Data processing ; Databases, Factual ; Delay ; Delayed Diagnosis ; Demographics ; Diagnosis ; Disease control ; Employment ; Health care ; Health care industry ; Hemoptysis ; Humans ; Income ; Independent variables ; Medical diagnosis ; Mortality ; Odds Ratio ; Patients ; Public Health ; Sex Factors ; Smear ; Socioeconomic Factors ; Sputum ; Sputum - microbiology ; Studies ; Systematic review ; Travel ; Traveltime ; Tuberculosis ; Tuberculosis - diagnosis ; Tuberculosis - therapy
  • Is Part Of: PloS one, 2015-03, Vol.10 (3), p.e0120088-e0120088
  • Description: Delays in tuberculosis (TB) diagnosis and treatment is a major barrier to effective management of the disease. Determining the factors associated with patient and provider delay of TB diagnosis and treatment in Asia may contribute to TB prevention and control. We searched the PubMed, EMBASE and Web of Science for studies that assessed factors associated with delays in care-seeking, diagnosis, or at the beginning of treatment, which were published from January 1992 to September 2014. Two reviewers independently identified studies that were related to our meta-analysis and extracted data from each study. Independent variables were categorized in separate tables for patient and provider delays. Among 45 eligible studies, 40 studies assessed patient delay whereas 30 assessed provider delay. Cross-sectional surveys were used in all but two articles, which included 17 countries and regions. Socio-demographic characteristics, TB-related symptoms and medical examination, and conditions of seeking medical care in TB patients were frequently reported. Male patients and long travel time/distance to the first healthcare provider led to both shorter patient delays [odds ratio (OR) (95% confidence intervals, CI) = 0.85 (0.78, 0.92); 1.39 (1.08, 1.78)] and shorter provider delays [OR (95%CI) = 0.96 (0.93, 1.00); 1.68 (1.12, 2.51)]. Unemployment, low income, hemoptysis, and positive sputum smears were consistently associated with patient delay [ORs (95%CI) = 1.18 (1.07, 1.30), 1.23 (1.02, 1.49), 0.64 (0.40, 1.00), 1.77 (1.07, 2.94), respectively]. Additionally, consultation at a public hospital was associated with provider delay [OR (95%CI) = 0.43 (0.20, 0.91)]. We propose that the major opportunities to reduce delays involve enabling socio-demographic factors and medical conditions. Male, unemployed, rural residence, low income, hemoptysis, positive sputum smear, and long travel time/distance significantly correlated with patient delay. Male, long travel time/distance and consultation at a public hospital were related to provider delay.
  • Publisher: United States: Public Library of Science
  • Language: English
  • Identifier: ISSN: 1932-6203
    EISSN: 1932-6203
    DOI: 10.1371/journal.pone.0120088
    PMID: 25807385
  • Source: Public Library of Science (PLoS) Journals Open Access
    Geneva Foundation Free Medical Journals at publisher websites
    MEDLINE
    PubMed Central
    Directory of Open Access Journals
    ProQuest Central
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