Pulmonology Department, Hospital Pedro Hispano - Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal; TB Outpatient Clinic (CDP) Matosinhos - Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal.
Pulmonology Department, Centro Hospitalar Vila Nova de Gaia/Espinho; TB Outpatient Clinic (CDP) Vila Nova de Gaia, Vila Nova de Gaia Portugal; Faculty of Medicine of the University of Porto (FMUP), Porto Portugal; Institute of Public Health (ISPUP), University of Porto, Porto Portugal.
Pulmonology. 2024 Mar-Apr;30(2):130-136. doi: 10.1016/j.pulmoe.2021.05.004. Epub 2021 Jun 22.
Excessive delay in the diagnosis of Tuberculosis may have a negative impact on the epidemiological control and elimination of this disease. An accurate determination and analysis of delay times may help identify where and how to improve Tuberculosis diagnosis according to local needs. The Portuguese Tuberculosis Surveillance System - SVIG-TB - is the main source of data regarding diagnosis delay. However, to our knowledge, there has been no recent evaluation of its data. This study's primary aim was to conduct a thorough quantitative and qualitative evaluation of data obtained from the SVIG-TB registry concerning the delay in Tuberculosis diagnosis in Matosinhos, a Portuguese municipality.
All patients living in the Matosinhos municipality diagnosed with Tuberculosis between January 1 2012 and December 31 2019 were identified and individual SVIG-TB records retrieved. Patient-related, Healthcare-related and Total delay in Tuberculosis diagnosis were determined based on data obtained from this source and compared to data recovered from patient record review. Missing data, registering errors and differences in diagnosis delay between these two sources were analysed and compared. Subsequently, diagnosis delay data from a recent Portuguese nationwide SVIG-TB paper, covering years 2010 to 2014, was compared to local SVIG-TB and patient record review data.
This study identified a significantly greater percentage of cases with missing data on delay in SVIG-TB records when compared to Patient Record Review (57.2% versus 1.11%). The median patient-related, healthcare-related and Total delay in Tuberculosis diagnosis were of 17, 30 and 68 days, respectively, in the SVIG-TB based data. A significant underestimation of healthcare-related and total Tuberculosis diagnosis delay was identified in SVIG-TB data when compared to Patient Record Review. There was no significant difference between Patient-related delays determined from these two sources. Compared to the national study results, missing values were more common in this data set (57.2 vs 44.6%), mainly due to the absence of patient-related delay data. Median Total and Healthcare-related delays were significantly greater in Matosinhos Municipality, regardless of the data source (SVIG-TB or Patient Record Review). The patient-related delay was, conversely, shorter.
SVIG-TB has been crucial in guiding National Public Health policies on the path towards Tuberculosis elimination in Portugal. However, there is still room for improvement. These results provide a basis for further reflection on the shortcomings and potential of SVIG-TB in guiding the national Tuberculosis program.
结核病诊断的过度延迟可能对这种疾病的流行病学控制和消除产生负面影响。准确确定和分析延迟时间可以帮助根据当地需求确定和分析在哪里以及如何改进结核病诊断。葡萄牙结核病监测系统-SVIG-TB-是有关诊断延迟的主要数据来源。然而，据我们所知，最近没有对其数据进行评估。本研究的主要目的是对来自 SVIG-TB 登记处的有关马托西纽什（葡萄牙市镇）结核病诊断延迟的数据进行全面的定量和定性评估。
确定了 2012 年 1 月 1 日至 2019 年 12 月 31 日期间居住在马托西纽什市的所有诊断为结核病的患者，并检索了每个 SVIG-TB 记录。根据该来源获得的数据确定了与患者相关的、与医疗保健相关的和结核病诊断的总延迟，并与从患者记录审查中恢复的数据进行了比较。分析并比较了这两个来源之间的缺失数据、登记错误以及诊断延迟之间的差异。随后，将涵盖 2010 年至 2014 年的最近一篇葡萄牙全国性 SVIG-TB 论文中的诊断延迟数据与当地 SVIG-TB 和患者记录审查数据进行了比较。
与患者记录审查相比，SVIG-TB 记录中延迟的缺失数据百分比显著更高（57.2%比 1.11%）。根据 SVIG-TB 数据，结核病患者相关、医疗保健相关和总诊断延迟的中位数分别为 17、30 和 68 天。与患者记录审查相比，SVIG-TB 数据中医疗保健相关和总结核病诊断延迟被显著低估。从这两个来源确定的患者相关延迟没有显著差异。与全国性研究结果相比，该数据集的缺失值更为常见（57.2%比 44.6%），主要是由于缺乏患者相关的延迟数据。无论数据源（SVIG-TB 或患者记录审查）如何，马托西纽什市的总延迟和医疗保健相关的延迟均显著更高。相反，患者相关的延迟更短。
SVIG-TB 对于指导葡萄牙消除结核病的国家公共卫生政策至关重要。然而，仍有改进的空间。这些结果为进一步反思 SVIG-TB 在指导国家结核病计划方面的缺点和潜力提供了依据。
