Time delays in diagnosis of pulmonary tuberculosis: a systematic review of literature.
Time delays in diagnosis of pulmonary tuberculosis: a systematic review of literature.
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DOI：
10.1186/1471-2334-9-91
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发表时间：
2009-06-11
影响因子：
3.7
通讯作者：
Van den Ende J
中科院分区：
文献类型：
--
作者：
Sreeramareddy CT;Panduru KV;Menten J;Van den Ende J
肺结核诊断的延误导致严重程度、死亡率和传播率的增加。不同的调查人员都报告了结核病诊断的延误。我们的目的是总结关于结核病诊断延迟的数据。对文献进行了系统的综述。应用计算机检索Medline和EMBASE数据库1990-2008年间的文献。我们使用了以下搜索词：延迟、结核病、诊断和寻求帮助/寻求健康的行为，没有语言限制。此外，还手工搜索了四种主要结核病期刊的索引。研究人员联系了结核病学科专家和初步研究的作者。还检索了参考文献列表、综述文章和教科书章节。对所有研究进行方法学质量评估。仅对涂片/培养阳性结核病患者进行了研究，并报告了总体、患者和医疗保健系统的延误情况。通过搜索，总共确定了419项潜在的研究。有52项研究符合审查条件。低收入国家和高收入国家报告的平均(中位数或平均)总延误、病人延误和卫生系统延误的范围分别为25-185天、4.9-162天和2-87天。患者的平均延误与卫生系统的延误相似(28.7天对25天)。低收入国家的患者延误和卫生系统延误(31.7天和28.5天)与高收入国家报告的(25.8天和21.5天)相似。这项审查的结果表明，有必要修订病例发现战略。报告的直接监督治疗的高治疗成功率可能会被缩短诊断延迟的措施所补充。这可能导致感染病例的减少和更好的结核病控制。
Delay in diagnosis of pulmonary tuberculosis results in increasing severity, mortality and transmission. Various investigators have reported about delays in diagnosis of tuberculosis. We aimed at summarizing the data on these delays in diagnosis of tuberculosis. A systematic review of literature was carried out. Literature search was done in Medline and EMBASE from 1990 to 2008. We used the following search terms: delay, tuberculosis, diagnosis, and help-seeking/health-seeking behavior without language restrictions. In addition, indices of four major tuberculosis journals were hand-searched. Subject experts in tuberculosis and authors of primary studies were contacted. Reference lists, review articles and text book chapters were also searched. All the studies were assessed for methodological quality. Only studies carried out on smear/culture-positive tuberculosis patients and reporting about total, patient and health-care system delays were included. A total of 419 potential studies were identified by the search. Fifty two studies qualified for the review. The reported ranges of average (median or mean) total delay, patient delay, health system delay were 25–185 days, 4.9–162 days and 2–87 days respectively for both low and high income countries. Average patient delay was similar to health system delay (28.7 versus 25 days). Both patient delay and health system delay in low income countries (31.7 days and 28.5 days) were similar to those reported in high income countries (25.8 days and 21.5 days). The results of this review suggest that there is a need for revising case-finding strategies. The reported high treatment success rate of directly observed treatment may be supplemented by measures to shorten the delay in diagnosis. This may result in reduction of infectious cases and better tuberculosis control.
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DOI：
10.1016/j.trstmh.2004.07.005
发表时间：
2005-05-01
影响因子：
2.2
作者：
Cheng, G;Tolhurst, R;Tang, S
通讯作者：
Tang, S
影响因子：
3.2
作者：
Dye, C;Watt, CJ;Williams, BG
通讯作者：
Williams, BG
影响因子：
9.3
作者：
Heller, Richard F.;Gemmell, Islay;Volmink, James A.
通讯作者：
Volmink, James A.
影响因子：
3.2
作者：
Karim, Fazlul;Islam, Md. Akramul;Diwan, Vinod K.
通讯作者：
Diwan, Vinod K.
影响因子：
4.5
作者：
Kiwuwa MS;Charles K;Harriet MK
通讯作者：
Harriet MK