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Master Thesis

Les délais diagnostiques de la tuberculose en Isère

Abstract : It has been well known for a number of years that the time taken to diagnose, as well as representing a critical factor for the individual concerned, is one of the principal components limiting the eradication of tuberculosis. This diagnostic delay can be divided into patient delay (from the first symptom to the first medical consultation) and health service delay (from the first consultation to the diagnosis). We described this delays in a series of 97 patients for whom an obligatory declaration of tuberculosis was made between 1st December 2009 and 31st December 2010. We subsequently analysed the factors influencing the time taken for diagnosis and the consequences engendered by a delayed diagnosis. The median total diagnostic delay was 91 days, the patient delay, 16 days and the health service delay, 28 days. The patient delay was increased by precarity and recent immigration, whereas it was reduced by the presence of fever. The health service delay was increased if the patient was a smoker, and was reduced if the patient was precarious, was a recent migrant or did not have a family doctor, if the direct examination of sputum was positive or if the X-ray was evocator. We did not bring to light the consequence of a delayed diagnosis in terms of morbidity and mortality but the patients having a prolonged patient delay had more often a positive respiratory samples upon direct examination and an evocator X-ray. Public health measures adapted to the factors which prolong the time taken to diagnose would certainly enable an improvement in the care of patients and limit transmission of the illness.
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Master Thesis
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Submitted on : Thursday, May 17, 2012 - 3:36:45 PM
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  • HAL Id : dumas-00632613, version 1

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Alexandra Fuin Roye. Les délais diagnostiques de la tuberculose en Isère. Médecine humaine et pathologie. 2011. ⟨dumas-00632613⟩

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