Skip Navigation

The European Journal of Public Health 2004 14(2):151-155; doi:10.1093/eurpub/14.2.151
© 2004 by European Journal of Public Health
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (5)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Díez, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Díez, M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Infectious Diseases

Determinants of patient delay among tuberculosis cases in Spain

M. Díez1, M.J. Bleda1, J. Alcaide2, T. Caloto3, C. Castells4, J.I. Cardenal5, A. Domínguez2, P. Gayoso6, G. Gutiérrez7, C. Huerta8, M.J. López9, T. Moreno, F. Muñoz11, C. Navarro12, M. Picó13, F. Pozo14, J.R. Quirós15, F. Robles16, J.M. Sánchez17, H. Vanaclocha18 and T. Vega19 Multicentre Project for Tuberculosis Research (MPTR) Study Group20

1 Unidad de Investigación en TB, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid 2 Dirección General de Salud Pública, Generalitat de Catalunya, Barcelona 3 Merck Sharp and Dohme de España S.A. Madrid 4 Delegación Territorial de Sanidad, Gobierno Autónomo Vasco, Bilbao 5 Dirección General de Salud Pública, Junta de Extremadura, Badajoz 6 Complejo Hospitalario Cristal-Piñor, Orense 7 Dirección General de Salud Pública, Junta de Comunidades de Castilla-La Mancha, Toledo 8 Centro Español de Investigación Farmacoepidemiológica (CEIFE), Madrid 9 Dirección General de Salud, Gobierno Autónomo de La Rioja, Logroño 10 Unidad de Coordinación y Desarrollo de Investigación en Enfermería, Instituto de Salud Carlos III, Madrid 11 Hospital Universitario de Valme, Sevilla 12 Servicio de Epidemiología, Consejería de Sanidad y Consumo, Murcía 13 Dirección General de Salud Pública, Junta de Andalucía, Sevilla 14 Hospital Doce de Octubre, Madrid 15 Dirección General de Salud Pública, Principado de Asturias, Oviedo 16 Consejería de Sanidad, Consejo de Gobierno de la Ciudad Autónoma de Melilla, Melilla 17 Consejería de Sanidad, Consumo y Deportes, Consejo de Gobierno de la Ciudad Autónoma de Ceuta, Ceuta 18 Dirección General de Salud Pública, Generalitat Valenciana, Valencia 19 Dirección General de Salud Pública y Asistencia, Junta de Castilla y León, Valladolid, Spain 20 Members listed in: (National Centre for Epidemiology Server/TB Research Unit), http://193.146.50.130/uit/Grupos de Trabajo (Working Groups).htm

Background: Patient delay was investigated in a cohort of TB patients identified from May 1996 until April 1997 in 13 Autonomous Regions in Spain. The study covered almost 67% of the total Spanish population. Methods: Data were collected from clinical records. Using unconditional logistic regression with two different cut-off points to define ‘patient delay’ (the median and 75th percentile), the association between patient delay and different factors was estimated. Results: A total of 7,037 cases were included. Median and 75th percentile delays were 22 and 57 days respectively. Factors associated with patient delay greater than the median (p<0.05) were: non-respiratory symptoms of TB and age over 14 years, although the effect of age was not linear. Furthermore, an interaction was observed between intravenous drug user (IDU) and HIV status, in that, whereas patient delay was greater in IDUs than in non-IDUs among cases whose HIV status was either negative or unknown, among HIV-positive patients no such IDU-related differences were in evidence. Factors associated with extreme patient delay (greater than the 75th percentile) were essentially the same, but the above-described interaction disappeared, with IDU status showing no direct effect. In addition, likelihood of extreme patient delay increased in the case of alcoholism and female gender and decreased in the case of chronic renal failure, corticoid treatment, prison inmates and residents of old age homes. Conclusion: Although there is a universally enjoyed right to health care in Spain, some groups of TB patients could nevertheless be experiencing problems in seeking medical attention.

Keywords: HIV, patient delay, tuberculosis

Received 18 July 2002. Accepted 9 January 2003.

* Correspondence: Mercedes Díez, MD, PhD, Seconded National Expert, Poverty-related Diseases, Directorate-General for Research, European Commission, Office SDME 07/38, Square de Meeûs 8, B-1050 Bruxelles, Belgium, tel. +32 2 298 6728, fax +32 2 295 5365, e-mail: Mercedes.DIEZ-RUIZ-NAVARRO{at}cec.eu.int


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Int J STD AIDSHome page
M Shamaei, M Marjani, P Baghaei, E Chitsaz, E Rezaei Tabar, Z Abrishami, P Tabarsi, D Mansouri, and M R Masjedi
Drug abuse profile - patient delay, diagnosis delay and drug resistance pattern - among addict patients with tuberculosis
Int J STD AIDS, May 1, 2009; 20(5): 320 - 323.
[Abstract] [Full Text] [PDF]

Home page
 Eur J Public HealthHome page
S. Fazel and R. Benning
Natural deaths in male prisoners: a 20-year mortality study
Eur J Public Health, August 1, 2006; 16(4): 441 - 444.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.