Factors associated with delayed diagnosis of pulmonary tuberculosis with positive bacilloscopy in Bangui, Central Africa

Jean de Dieu Longo; Henri Saint Calvaire Diemer; Sylvain Honoré Woromogo; Herman Doyama-woza; Gaby Ferreol Melkisedeck Gotia-Dondoumba; Gérard Grésenguet

doi:10.18203/2394-6040.ijcmph20232355

Authors

Jean de Dieu Longo Public Health Department, Faculty of Health Sciences, University of Bangui, Central African Republic
Henri Saint Calvaire Diemer Public Health Department, Faculty of Health Sciences, University of Bangui, Central African Republic
Sylvain Honoré Woromogo School of Human and Veterinary Sciences, University of Bangui, Central African Republic
Herman Doyama-woza Public Health Department, Faculty of Health Sciences, University of Bangui, Central African Republic
Gaby Ferreol Melkisedeck Gotia-Dondoumba Public Health Department, Faculty of Health Sciences, University of Bangui, Central African Republic
Gérard Grésenguet Public Health Department, Faculty of Health Sciences, University of Bangui, Central African Republic

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20232355

Keywords:

Bacilloscopy, Central Africa, Diagnostic delay, Tuberculosis

Abstract

Background: A case of untreated bacteriologically confirmed pulmonary tuberculosis (BPT+) represents a reservoir for transmission of the disease. The objective of this study was to evaluate the delay and identify the determinants of the delay in the diagnosis of BPT+ in the diagnostic and treatment centers for tuberculosis (CDT) in Bangui.

Methods: An analytical cross-sectional survey was conducted. It included all new TB patients aged 15 years and older (145) who presented a positive bascilloscopy. Exhaustive recruitment was performed during the study period. Multiple logistic regression with OR (95% CI) for p<0.05 was used to establish the relationship between delayed diagnosis and patient characteristics.

Results: Patients ranged in age from 16 to 80 years with an average age of 33.81±12.18 years. The time to consultation and diagnosis >30 days after the onset of symptoms were 83.10% and 23.95%, respectively. In multivariate analysis, male patients [ORa=0.42 (0.19-0.93)]; patients residing in peri-urban areas [ORa=4.25 (2.10-9.02)]; patients using informal care facilities as first option [ORa=1.84 (1.47-3.38)] and not requesting acid-fast bacilli (AFB) test at first visit [ORa=6.09 (3.70-17.69)] were associated with risk of delayed diagnosis.

Conclusions: Early diagnosis and treatment of BPT+, which is the spreading form of the disease, remains a public health concern in our context. Supervision and coaching of health workers coupled with increased public awareness of TB will contribute to better control of the disease.

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