PMID- 34916453 OWN - NLM STAT- MEDLINE DCOM- 20220106 LR - 20220826 IS - 2212-554X (Electronic) IS - 2212-5531 (Print) IS - 2212-5531 (Linking) VI - 10 IP - 4 DP - 2021 Oct-Dec TI - Impact of early chest radiography on delay in pulmonary tuberculosis case notification in Ethiopia. PG - 364-372 LID - 10.4103/ijmy.ijmy_216_21 [doi] AB - BACKGROUND: One-third of tuberculosis (TB) cases are missed each year and delays in the diagnosis of TB are hampering the whole cascade of care. Early chest X-ray (CXR) in patients with cough irrespective of duration may reduce TB diagnostic and treatment delays and increase the number of TB patients put into TB care. We aimed to evaluate the impact of CXR on delay in the diagnosis of pulmonary tuberculosis (PTB) among people with cough of any duration. METHODS: A facility-based cross-sectional study was conducted in four selected health facilities from two regions and two city administrations of Ethiopia. Patients who sought health care were screened for cough of any duration, and those with cough underwent CXR for PTB and their sputum specimens were tested for microbiological confirmation. Delays were followed up and calculated using median and inter-quartile range (IQR) to summarize (first onset of cough to first facility visit, >/=15 days), diagnosis delay (first facility visit to date of PTB diagnosis, >7 days), and total delay (first onset of cough to date of PTB diagnosis, >21 days). Kruskal-Wallis and Mann-Witney tests were used to compare the delays among independent variables. RESULTS: A total of 309 PTB cases were consecutively diagnosed of 1853 presumptive TB cases recruited in the study that were identified from 2647 people who reported cough of any duration. The median (IQR) of patient delay, diagnosis delay, and the total delay was 30 (16-44), 1 (0-3), and 31 (19-48) days, respectively. Patients' delay contributed a great role in the total delay, 201/209 (96.2%). Median diagnosis delay was higher among those that visited health center, diagnosed at a facility that had no Xpert mycobacterium tuberculosis (MTB)/RIF assay, radiologist, or CXR (P < 0.05). Factors associated with patients delay were history of previous TB treatment (adjusted prevalence ratio [aPR] = 0.79, 95% confidence interval [CI]: 0.63-0.99) and history of weight loss (aPR = 1.12; 95% CI: 1.0-1.25). Early CXR screening for cough of <2 weeks duration significantly reduced the patients' delay and thus the total delay, but not diagnostic delay alone. CONCLUSION: Early screening using CXR minimized delays in the diagnosis of PTB among people with cough of any duration. Patients' delay was largest and contributed great role in the delay of TB cases. Screening by cough of any duration and/or CXR among people seeking healthcare along with ensuring the availability of Xpert MTB/RIF assay and skilled human power at primary healthcare facilities are important to reduce patient and diagnostic delays of PTB in Ethiopia. FAU - Mohammed, Hussen AU - Mohammed H AD - Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa; Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. FAU - Oljira, Lemessa AU - Oljira L AD - Department of Public Health, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia. FAU - Roba, Kedir Teji AU - Roba KT AD - Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia. FAU - Ngadaya, Esther AU - Ngadaya E AD - Muhimbili Research Centre, National Institute for Medical Research, Dares Saalem, Tanzania. FAU - Tesfaye, Dagmawit AU - Tesfaye D AD - Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. FAU - Manyazewal, Tsegahun AU - Manyazewal T AD - Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. FAU - Yimer, Getnet AU - Yimer G AD - Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University; Ohio State Global One Health Initiative, Office of International Affairs, The Ohio State University, Addis Ababa, Ethiopia. LA - eng GR - D43 TW009127/TW/FIC NIH HHS/United States PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - India TA - Int J Mycobacteriol JT - International journal of mycobacteriology JID - 101615660 SB - IM MH - Cross-Sectional Studies MH - Ethiopia/epidemiology MH - Humans MH - *Mycobacterium tuberculosis MH - Radiography MH - Sputum MH - *Tuberculosis, Pulmonary/diagnostic imaging/epidemiology PMC - PMC9400111 MID - NIHMS1830776 OTO - NOTNLM OT - Active case-finding OT - Ethiopia OT - X-ray OT - Xpert mycobacterium tuberculosis/RIF assay OT - chest radiography OT - delay OT - diagnosis OT - screening OT - tuberculosis COIS- None EDAT- 2021/12/18 06:00 MHDA- 2022/01/07 06:00 PMCR- 2022/08/24 CRDT- 2021/12/17 06:14 PHST- 2021/12/17 06:14 [entrez] PHST- 2021/12/18 06:00 [pubmed] PHST- 2022/01/07 06:00 [medline] PHST- 2022/08/24 00:00 [pmc-release] AID - IntJMycobacteriol_2021_10_4_364_332367 [pii] AID - 10.4103/ijmy.ijmy_216_21 [doi] PST - ppublish SO - Int J Mycobacteriol. 2021 Oct-Dec;10(4):364-372. doi: 10.4103/ijmy.ijmy_216_21.