Tuberc Respir Dis.  1987 Mar;34(1):51-56. 10.4046/trd.1987.34.1.51.

A Clinical Study of Patients Delay and Doctor`s Delay in Case-finding of Pulmonary Tuberculosis

• KMID: 2528671
• DOI: http://doi.org/10.4046/trd.1987.34.1.51

Abstract

The authors made a study on patient’s delay and doctor's delay among 310 patients who were treated at our out-patient clinic from Jan. 1986 to Dec. 1986 The following results were obtained: 1) The ratio of male to female was 1.2:1. The highest incidence was seen in the third and fourth decades of life, while the lowest was in below second decades. 2) Two hundred and sixty-four patients (85.2%) visited various kinds of medical institutions due to presence of symptoms; 42 patients (13.5%) because of pulmonary tuberculosis revealed by various health examinations, and 4 patients (1.3%) for other reasons. 3) The first symptoms were cough productive of sputum (29.7%), cough (22.3%), hemoptysis (9.0%), easy fatigability (2.9%), blood-tinged sputum (5.5%), and sputum (2.9%) in order of frequency. 4) The durations of patient’s delay were as follows: 1 to less than 2 months' delay 19%, 1 to less than 2 weeks' delay 5.8%, 2 weeks’ to less than 1 month’s delay 8.1 %, 2 to less than 3 months' delay 7.7%, 3 to less than 4 months' delay 12.6%, and more than 1 year’s delay 6.1 %. 5) In order to seek first help, 174 patients (56.1%) visited hospitals and/or clinics, 75 patients (24.2%) health centers, and 6 patients (1.9%) tuberculosis specialists' clinics. 6) Initial diagnoses were made in all patients; 303 patients (97.7%) by roentgenographic examinations, 123 patients (97.7%) by sputum smear examinations, and 78 patients (25.2%) by sputum culture examinations. 7) 36 patients (1 1.6%) were initially diagnosed as having diseases other than pulmonary tuberculosis; 11 patients having common cold, 4 patients bronchitis, 6 patients pleurisy, 4 patients pneumonia, 2 patients bronchiectasis, 1 patient pulmonary paragonimiasis. 3 patients were initially notified as normal. 8) The number of general hospitals and health centers visited for final diagnosis increased by 6% and 7%, respectively, while the number of private clinics decreased by 8%, compared with the number of those visited for initial diagnosis. 9) In the methods of establishing the final diagnosis, x-ray examinations and sputum smear and culture examinations increased by 2%, 17%, and 18%, respectively, in comparison with those of initial diagnoses. 10) The durations of doctor’s delay were as follows: less than 1 week’s delay 79.4%, 1 to less than 2 weeks’ delay 3.2%, 2 weeks' to less than 1 month’s delay 2.6%, 1 to less than 2 months' delay 6.5%, 2 months' to less than 1 year's delay 6.5%, and more than 1 year's delay 1.9%. judging from the above results, we regard it reasonable to suggest that patient’s delay should be shortened by strengthening health education of the public so as to make them visit health centers or other medical institutions as early as possible whenever symptoms suggestive of pulmonary tuberculosis occur and that doctor’s delay be reduced by conducting bacteriological and radiological examinations more thoroughly as well as by inventing a more rapid and reliable diagnostic method.