Aldhubhani, Adel Hamood Noman
(2013)
Factors Determining The Delay Of Tb
Diagnosis And Its Effect On The Disease
Transmission In Yemen.
PhD thesis, Universiti Sains Malaysia.
Abstract
Tuberculosis (TB) still remains a leading cause of mortality and morbidity with an
estimation of 8.8 million new cases in the world. The global incidence rate of TB
was growing at approximately 1.1% per year and the number of cases at 2.4% per
year. Delay in seeking care of TB increase transmission of pulmonary tuberculosis
as well as the burden of TB, which remains high in developing countries. This delay
in the diagnosis of TB also could result in increased patient morbidity and mortality.
However, early diagnosis and immediate initiation of treatment are essential for an
effective TB prevention and control. The aim of this study was to evaluate the delay
in TB diagnosis and its effect on TB transmission in addition to its effect on prediagnosis
cost. The study was carried out in 3 phases in a referral centre of
tuberculosis at Sana’a city, Yemen. Phase One was concerned of a general
identification of delay problem and its associated factors. Phase Two was aimed to
assess the effect of delay on TB transmission among close contacts. In Phase Three,
the relation between pre-diagnosis cost and delay diagnosis of TB patients was
assessed. About 505 new smears positive TB patients were recruited to this study.
All of the 505 were subjected to interview questionnaire. Moreover, 266 close
contacts were subjected to Tuberculin Screening Test (TST). This TST tool was used
in phase two of this study. The results obtained in Phase One revealed that, median
delay was 60 days for total, 30 days for patient and 10 days for health care delay.
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