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Eslam Moradi-Asl 1 Article
The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data
Reza Ebrahimoghli, Hassan Ghobadi, Davoud Adham, Parviz Jangi, Abbas Abbasi-Ghahramanloo, Eslam Moradi-Asl
Epidemiol Health. 2022;44:e2022060.   Published online July 18, 2022
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AbstractAbstract AbstractSummary PDF
Early diagnosis is essential for effective tuberculosis (TB) control programs. Therefore, this study examined the risk of delays in TB diagnosis and associated factors in Ardabil Province in northwest Iran from 2005 to 2016.
This longitudinal retrospective cohort study was conducted using data obtained from the Iranian National Tuberculosis Control Program at the provincial level between 2005 and 2016. The total delay in diagnosis was defined as the time interval (days) between the onset of symptoms and TB diagnosis. Survival analysis was conducted to analyze the delay in diagnosis. Associated factors were identified using a Cox proportional hazards model.
A total of 1,367 new TB cases were identified. The 12-year median diagnostic delay was 45 days (interquartile range [IQR], 30-87). The annual median diagnostic delay decreased from 68 days (IQR, 33-131) in 2005 to 31 days (IQR, 30-62) in 2016. The probability of a delay in TB diagnosis decreased by 5.0% each year (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.04 to 1.07). Residence in a non-capital county (HR, 0.83; 95% CI, 0.74 to 0.92) and referral from the private health system (HR, 0.74%; 95% CI, 0.65 to 0.84) were significantly associated with an increased risk of delay in TB diagnosis over the 12-year study period.
The median delay decreased during the study period. We identified factors associated with a longer delay in TB diagnosis. These findings may be useful for further TB control plans and policies in Iran.
Key Message
A longitudinal analysis of tuberculosis surveillance data from northwest Iran showed that during the 12-year period from 2005 to 2016, a total of 1,367 tuberculosis cases were registered, of whom 942 patients had a prolonged diagnostic delay (>30 days) and the probability of a delay in tuberculosis diagnosis decreased by 5.0% each year.


Citations to this article as recorded by  
  • Assessing heterogeneity of patient and health system delay among TB in a population with internal migrants in China
    Ruoyao Sun, Zheyuan Wu, Hongyin Zhang, Jinrong Huang, Yueting Liu, Meiru Chen, Yixiao Lv, Fei Zhao, Yangyi Zhang, Minjuan Li, Jiaqi Yan, Hongbing Jiang, Yiqiang Zhan, Jimin Xu, Yanzi Xu, Jianhui Yuan, Yang Zhao, Xin Shen, Chongguang Yang
    Frontiers in Public Health.2024;[Epub]     CrossRef

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