Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Aug 26:7:24909.
doi: 10.3402/ehtj.v7.24909. eCollection 2014.

Two vicious circles contributing to a diagnostic delay for tuberculosis patients in Arkhangelsk

Vladimir N Kuznetsov  1 , Andrej M Grjibovski  2 , Andrej O Mariandyshev  3 , Eva Johansson  4 , Gunnar A Bjune  5
Affiliations

Two vicious circles contributing to a diagnostic delay for tuberculosis patients in Arkhangelsk

Vladimir N Kuznetsov et al. Emerg Health Threats J. .

Abstract

Setting: Delay in tuberculosis (TB) diagnosis increases the infectious pool in the community and the risk of development of resistance of mycobacteria, which results in an increased number of deaths.

Objective: To describe patients' and doctors' perceptions of diagnostic delay in TB patients in the Arkhangelsk region and to develop a substantive model to better understand the mechanisms of how these delays are linked to each other.

Design: A grounded theory approach was used to study the phenomenon of diagnostic delay. Patients with TB diagnostic delay and doctors-phthisiatricians were interviewed.

Results: A model named 'sickness trajectory in health-seeking behaviour among tuberculosis patients' was developed and included two core categories describing two vicious circles of diagnostic delay in patients with TB: 'limited awareness of the importance to contact the health system' and 'limited resources of the health system' and the categories: 'factors influencing health-seeking behaviour' and 'factors influencing the health system effectiveness'. Men were more likely to report patient delay, while women were more likely to report health system delay.

Conclusions: To involve people in early medical examinations, it is necessary to increase alertness on TB among patients and to improve health systems in the districts.

Keywords: grounded theory; health system delay; patient delay; tuberculosis.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Model of the sickness trajectory, including categories influencing the process of TB diagnosis and treatment.
See this image and copyright information in PMC

References

    1. Meintjes G, Schoeman H, Morroni C, Wilson D, Maartens G. Patient and provider delay in tuberculosis suspects from communities with a high HIV prevalence in South Africa: a cross-sectional study. BMC Infect Dis. 2008;8:72. - PMC - PubMed
    1. Diez M, Bleda MJ, Alcaide J, Castells C, Cardenal JI, Dominguez A, et al. Determinants of health system delay among confirmed tuberculosis cases in Spain. Eur J Public Health. 2005;15(4):343–349. - PubMed
    1. Karim F, Islam MA, Chowdhury AM, Johansson E, Diwan VK. Gender differences in delays in diagnosis and treatment of tuberculosis. Health Policy Plan. 2007;22(5):329–334. - PubMed
    1. Storla DG, Yimer S, Bjune GA. A systematic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health. 2008;8:15. - PMC - PubMed
    1. Yimer S, Bjune G, Alene G. Diagnostic and treatment delay among pulmonary tuberculosis patients in Ethiopia: a cross sectional study. BMC Infect Dis. 2005;5:112. - PMC - PubMed

LinkOut - more resources