Division of Pediatric Infectious Diseases, Department of Pediatrics, Radboud University Nijmegen Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
Infection. 2010 Dec;38(6):433-46. doi: 10.1007/s15010-010-0051-y. Epub 2010 Sep 29.
Diagnostic delay in patients with tuberculosis (TB) leads to ongoing TB transmission, higher mortality rates and increased patient and government health expenditure. Qualitative research focussed on patients' self-perceptions of disease and their care-seeking behaviour helps to guide health education programmes by providing us with the understanding of the knowledge, attitudes and practices that underlie diagnostic delay.
Semi-structured interviews with 28 recently diagnosed TB patients and four traditional healers were conducted. The interviews were audio-recorded and content analysis was performed.
The median total delay was 188 days. The health provider delay (31 days) was longer than the patient delay (21 days) and the health system delay (26 days). The health system delay was longest in patients not being diagnosed at their first hospital visit and subsequently visiting other health care providers, mostly traditional healers.
A poor knowledge of TB signs and symptoms and patients' beliefs about curses as the origin of diseases lead to delayed care-seeking at the hospital level in an area of North-Western Tanzania. Failure to identify TB cases by formal and non-formal health providers indicates that the education of both communities as well as health workers is essential in order to reduce diagnostic delays.
肺结核（TB）患者的诊断延迟会导致持续的 TB 传播、更高的死亡率以及增加患者和政府的医疗支出。关注患者对疾病的自我认知和求医行为的定性研究有助于通过了解导致诊断延迟的知识、态度和实践，为健康教育计划提供指导。
对 28 名最近确诊的 TB 患者和 4 名传统治疗师进行了半结构化访谈。访谈进行了录音，并进行了内容分析。
总延迟中位数为 188 天。卫生服务提供者延迟（31 天）长于患者延迟（21 天）和卫生系统延迟（26 天）。在首次就诊未被诊断且随后就诊于其他医疗保健提供者（主要是传统治疗师）的患者中，卫生系统延迟最长。
在坦桑尼亚西北部的一个地区，对 TB 症状和体征的了解不足以及患者对疾病起源于诅咒的信念导致在医院层面寻求医疗的时间延迟。正规和非正规卫生服务提供者未能识别 TB 病例，这表明必须对社区和卫生工作者进行教育，以减少诊断延迟。
