Determinants of delay in the diagnosis and treatment of suspected tuberculosis by HIV status in South Africa
Date
2017
Authors
Kanje, Victor
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Introduction
Delays in diagnosing and treating tuberculosis increase the risk of transmission, morbidity
and mortality especially in low socio-economic settings with high HIV and TB rates. The
aim of this study was to determine factors associated with the delay in the diagnosis and
treatment of suspected TB by HIV status in hospitalised patients in South Africa.
Methods
This study was a secondary analysis of data from a three centre prospective cohort of
inpatients recruited between 2006 and 2009 that were clinically diagnosed with active TB
on admission.
Results
Data from 1018 patients (67% female) of a median age of 36 years (IQR: 30-44) with
known HIV status were analysed: 875 (86%) positive and 143 (14%) negative. HIV positive
patients had significantly longer median total delays relative to the negative (39 days,
IQR: 28-74 vs. 32 days, IQR: 21-56; p<0.02). Unemployment, seeking prior treatment and
use of cotrimoxazole predicted total delay in the HIV positive patients.
Conclusion
Patient delay is high in HIV positive patients compared to the HIV negative. Public health
interventions targeting earlier diagnosis of TB disease in HIV positive patients should be
enhanced.
Description
A research report submitted to the School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, in partial fulfillment of the requirements for the
degree
of
Masters in Science in Epidemiology and Biostatistics
June 2017