TB treatment delays in Taiwan

Older people suffer delayed tuberculosis treatment. A Taiwanese study of 78,118 pulmonary tuberculosis (PTB) cases, reported in the open access journal BMC Public Health has found that older people had both diagnosis and treatment delays in tuberculosis and those with an aboriginal background had a longer treatment delay.

Pesus Chou from the National Yang-Ming University in Taipei, Taiwan, studied information from the Taiwan TB reporting system over the period 2002 to 2006. She said, "According to literature review, diagnosis and treatment delay of tuberculosis (TB) may result in more extensive disease and more complications, which in turn leads to a higher mortality. So, studies on delays are important. This is the first study to investigate delays using the Taiwan reporting system."

A period of longer than nine days between medical examination and TB diagnosis was defined as a diagnosis delay and a period of longer than two days between diagnosis and initiation of therapy was defined as a treatment delay. According to Chou, "During the five-year study period, 78,118 new PTB patients were reported. Of these, 19,413 (24.9%) experienced a diagnosis delay and 14,270 (20.3%) experienced a treatment delay."

Risk factors for a delayed diagnosis included increased age and living with family (as compared with living alone). Risk factors for delayed treatment also included age, as well as having an aboriginal background or living alone. Commenting on the treatment delay for aboriginal patients, Chou said, "The medical service resources in aboriginal areas are relatively deficient. It should also be noted that the mortality rate and incidence of TB are much greater in aboriginal communities in Taiwan than in non-aboriginal areas."

1. Diagnosis and treatment delay among pulmonary tuberculosis patients identified using the Taiwan reporting enquiry system, 2002-2006
Hui-Ping Lin, Chung-Yeh Deng and Pesus Chou
BMC Public Health 2009, 9:55 doi:10.1186/1471-2458-9-55

Article available at journal website: http://www.biomedcentral.com/1471-2458/9/55/

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