Ahammad A M, Islam M N, Yesmin S, Islam S, Fardous J
Dr Alamgir Mustak Ahammad, Senior Consultant (Medicine), Sherpur District Hospital, Sherpur, Bangladesh; E-mail:
Mymensingh Med J. 2025 Apr;34(2):461-468.
Patients with systemic lupus erythematosus (SLE) often ignore the initial symptoms of the disease and delay in seeking medical care, which ultimately prolongs the diagnostic delay. The objective of the present study was to explore the health-seeking behavior and the factors associated with diagnostic delay in SLE patients. This cross-sectional study was conducted among 85 patients suffering from SLE who attended the Lupus Clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2012 to June 2013. Socio-demographic and disease-related data were collected by face-to-face interviews. Diagnostic delay was defined as the period of time from onset of initial symptoms of SLE and confirmation of diagnosis. Factors associated with diagnostic delay were determined by appropriate statistical test. Almost 75.0% of the patients visited qualified physicians and their average interval of seeking medical care after the onset of SLE symptoms was 1.4±2.6 months. The average interval between the onset of initial symptoms and the diagnosis of SLE was 12.3 (SD 13.9) months. It was longer in female patients (13.2 months versus 7.3 months in male). Early medical contact and visiting qualified physicians also shortened the diagnostic delay of SLE. Patients presenting with joint pain and fever had a longer diagnostic delay than those who presented with oral ulcers, malar rash and lupus nephritis. Patients' health-seeking behavior, such as delayed medical care seeking, as well as presenting with nonspecific symptoms, such as fever and joint pain, which mimic other diseases, increases the diagnostic delay in SLE patients. These symptoms should be considered for the evaluation of immunological evidence of SLE.
系统性红斑狼疮（SLE）患者常常忽视该病的初始症状，就医延迟，这最终延长了诊断延迟时间。本研究的目的是探讨SLE患者的就医行为以及与诊断延迟相关的因素。这项横断面研究于2012年1月至2013年6月在孟加拉国达卡班加班德谢赫穆吉布医科大学狼疮诊所就诊的85例SLE患者中进行。通过面对面访谈收集社会人口统计学和疾病相关数据。诊断延迟定义为从SLE初始症状出现到确诊的时间段。通过适当的统计检验确定与诊断延迟相关的因素。近75.0%的患者就诊于合格医生，SLE症状出现后他们寻求医疗护理的平均间隔时间为1.4±2.6个月。初始症状出现与SLE诊断之间的平均间隔时间为12.3（标准差13.9）个月。女性患者的间隔时间更长（女性为13.2个月，男性为7.3个月）。早期就医和就诊于合格医生也缩短了SLE的诊断延迟。出现关节疼痛和发热的患者比出现口腔溃疡、蝶形红斑和狼疮性肾炎的患者诊断延迟时间更长。患者的就医行为，如延迟寻求医疗护理，以及出现模仿其他疾病的非特异性症状，如发热和关节疼痛，会增加SLE患者的诊断延迟。在评估SLE的免疫学证据时应考虑这些症状。
