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Observational Study
. 2013 Jun 27;8(6):e67516.
doi: 10.1371/journal.pone.0067516. Print 2013.

Effect of Diagnostic and Treatment Delay on the Risk of Tuberculosis Transmission in Shenzhen, China: An Observational Cohort Study, 1993-2010

Shiming Cheng  1 , Wei Chen, Yingzhou Yang, Ping Chu, Xiaoli Liu, Meigui Zhao, Weiguo Tan, Li Xu, Qingfang Wu, Hongyun Guan, Jinhong Liu, Haitao Liu, Ray Y Chen, Zhongwei Jia
Affiliations
Observational Study

Effect of Diagnostic and Treatment Delay on the Risk of Tuberculosis Transmission in Shenzhen, China: An Observational Cohort Study, 1993-2010

Shiming Cheng et al. PLoS One. .

Abstract

Introduction: To understand better the risk of tuberculosis transmission with increasing delay in tuberculosis treatment, we undertook a retrospective cohort study in Shenzhen, China.

Methods: All pulmonary tuberculosis cases in the Shenzhen tuberculosis surveillance database from 1993-2010 were included. Sputum smear positivity and presence of pulmonary cavity were used as proxies for risk of tuberculosis transmission.

Results: Among 48,441pulmonary tuberculosis cases, 70% presented with symptoms of pulmonary TB, 62% were sputum smear positive, and 21% had a pulmonary cavity on chest x-ray. 95.3% of patients self-presented for evaluation of illness after a median 58 days of delay after symptoms began. The proportion presenting sputum smear positive (p<0.001) and with a pulmonary cavity (p<0.001) increased significantly with increasing duration of delay.

Conclusions: Delayed diagnosis and treatment of tuberculosis is associated with a significantly increased risk of pulmonary sputum smear positivity and pulmonary cavity. To decrease risk of transmission, treatment delay needs to be reduced further.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. A. The trend of TB notification rate during 1993–2010.
B. Overall treatment delay trend over time stratified from 1993–2010. C. Proportion of different treatment delay durations over time from 1993–2010.
See this image and copyright information in PMC

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