Estudio del retraso diagnóstico de la tuberculosis pulmonar sintomática

Altet Gómez, M.N.; Alcaide Megías, J.; Canela Soler, J.; Milá Augé, C.; Jiménez Fuentes, M.A.; de Souza Galvao, M.L.; Solsona Peiró, J.

doi:10.1016/S0300-2896(03)75348-4

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and basic research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

It is a monthly journal in which all manuscripts are sent to peer-review and handled by the editor or an associate editor from the team and the final decision is made on the basis of the comments from the expert reviewers and the editors. The journal is published solely in English. All the published data is composed of novel manuscripts not previously published in any other journal and not being in consideration for publication in any other journal..

The journal is indexed at Science Citation Index Expanded, Medline/Pubmed, Embase and SCOPUS. Access to any published article is possible through the journal's web page as well as from Pubmed, ScienceDirect, and other international databases. Furthermore, the journal is also present in X, Facebook and Linkedin. Manuscripts can be submitted electronically using the following web site: https://www.editorialmanager.com/ARBR/.

Indexed in:

Current Contents/Clinical Medicine, JCR SCI-Expanded, Index Medicus/Medline, Excerpta Medica/EMBASE, IBECS, IME, SCOPUS, IBECS

Subscribe:

Impact factor

The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.

© Clarivate Analytics, Journal Citation Reports 2022

Impact factor 2023

8.7

Citescore

CiteScore measures average citations received per document published.

Citescore 2023

3.5

SJR

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SJR 2023

0.464

SNIP

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

SNIP 2023

0.482

View more metrics

Open Access Option

Journal Information

Previous article | Next article

Vol. 39. Issue 4.

Pages 146-152 (April 2003)

More article options

Pages 146-152 (April 2003)

DOI: 10.1016/S0300-2896(03)75348-4

Full text access

Estudio del retraso diagnóstico de la tuberculosis pulmonar sintomática

Pulmonary symptomatic tuberculosis' diagnostic delay study

Visits

15156

Download PDF

M.N. Altet Gómeza,

Corresponding author

med025494@saludalia.com

Correspondencia: Unidad de Enfermedades del Tórax. Avda. de les Drassanes, 17-21. 08001 Barcelona. España

, J. Alcaide Megíasa, J. Canela Solerb, C. Milá Augéa, M.A. Jiménez Fuentesa, M.L. de Souza Galvaoa, J. Solsona Peiróa

a Unidad de Enfermedades del Tórax. Barcelona

b Cátedra de Bioestadística. Universidad de Barcelona. Barcelona. España

This item has received

15156 Visits

Article information

Statistics

Objetivo

Estudiar el retraso diagnóstico de la tuberculo-sis pulmonar (TBP) sintomática

Pacientes Y Métodos

Estudio prospectivo de casos nuevos sintomáticos de TBP (edad = 15 años) mediante entrevista estructurada al paciente y su familia. Las variables fundamentales analizadas fueron: retraso del enfermo (RE), retraso atribuible al médico (RM), retraso durante el proceso diagnóstico (RPD), retraso en el sistema sanitario (RSS) y retraso total (RT), esto es, el tiempo transcurrido desde el comienzo de los síntomas hasta el inicio del tratamiento de la TBP. Se realizó un análisis estadístico univariante, así como análisis multivariante para cada uno de los componentes del retraso diagnóstico

Resultados

Se estudió a 287 enfermos. La media en días ± desviación estándar (DE) fue para el RT y sus distintos componentes de 81,8 ± 77,3 en el RT, 43,3 ± 55,7 días en el RE, de 28,4 ± 59,6 días en el RM; para el RD, de 10,0 ± 17,7 días y en el RSS de 38,5 ± 62,5 días

Conclusiones

Dentro del elevado retraso diagnóstico de la TBP los enfermos son responsables del 50%. En el sistema sanitario el 18,5% de los enfermos sufrió un retraso diagnóstico mayor de 60 días, siendo los médicos responsables del 75% de la demora atribuible al sistema

Palabras clave:

Tuberculosis pulmonar

Retraso diagnóstico

Factores de riesgo

Objective

To study symptomatic pulmonary tuberculosis (PTB) diagnostic delay

Patients And Methods

Prospective study of new symptomatic PTB cases (aged = 15 years) by structured interview with the patients and their families. The main variables analyzed were patient's delay (PD), doctor's delay (DD), diagnostic process delay (DPD), health care system delay (HCSD) and total delay between the onset of symptoms and start of treatment (TD). Univariate and multivariate statistical analyses were performed for each component of delay

Results

Two hundred eighty-seven patients were studied. The mean delays in days ± standard deviations were TD 81.8 ± 77.3; PD 43.3 ± 55.7; DD 28.4 ± 59.6; DPD 10.0 ± 17.7, and HCSD 38.5 ± 62.5

Conclusions

Patients are responsible for 50% of excess delay in diagnosing symptomatic PTB. Patients in the health care system experienced diagnostic delays over 60 days in 18.5% of cases, doctors being responsible for 75% of the diagnostic delay attributable to the system

Keywords:

Pulmonary tuberculosis

Diagnostic delay

Risk fac-tors

Full text is only aviable in PDF

Bibliografía

[1.]

WHO. Global Tuberculosis Program. Pio A, Chaulet P. Tuberculosis. Handbook. Geneve: WHO/TB/98.253

[2.]

J. Meijer, G.D. Barnettt, A. Kubik, K. Styblo.

Identification of sources of infection.

Selected Papers, 14 (1971), pp. 5-50

[3.]

C.J.L. Murray, K. Styblo, A. Rouillon.

Tuberculosis en los países en desarrollo: magnitud, intervenciones y costos.

Bol Un Int Tuber Enf Resp, 65 (1990), pp. 6-26

[4.]

Ministerio de Sanidad y Consumo.

Fondo de Investigación Sanitaria. Consenso Nacional para el Control de la Tuberculosis en España.

Med Clin (Barc), 98 (1992), pp. 24-31

[5.]

R. Vivancos Velasco, C. De Ancos Aracil, V. Estrada Pérez, M. Guijarro Rojas, M. Serrano Ros.

Tuberculosis como causa de muerte.

Rev Clin Esp, 198 (1998), pp. 601-603

Medline

[6.]

D.A. Enarson.

Failure of diagnosis: a key indicator in quality assurance of tuberculosis control [editorial].

Tuberc Lung Dis, 76 (1885), pp. 279-280

[7.]

N. Zafran, E. Heldal, S. Pavlovic, D. Vuckovic, J. Boe.

Why do our patients die of active tuberculosis in the era of effective therapy?.

Tub Lung Dis, 75 (1994), pp. 329-333

[8.]

Centers for Disease Control and Prevention.

Screening for tuberculosis and tuberculosis infection in high-risk populations. Recommendations of the Advisory Council for the Elimination of Tuberculosis.

Mmwr, 44 (1995),

[9.]

Instituto Nacional de Estadística.

Estructura de la Clasificación Nacional de Ocupaciones 1994 (CON-94),

[10.]

American Thoracic Society.

National Tuberculosis and Respiratory Disease Association.

Diagnostic standards and classification of tuberculosis. New York, (1969),

[11.]

T. Rodrigo, J.A. Caylá, H. Galdós-Tangüys, P. García de Olalla, M.T. Brugal, J.M. Jansá.

Proposing indicators for evaluation of tuberculosis control programmes in large cities based on the experience of Barcelona.

Int J Tuberc Lung Dis, 5 (2001), pp. 432-440

Medline

[12.]

J.A. Domingo Morera, J.A. Carretero Gracia, P. Val Adán, A. Pérez Trullén, J.M. Domingo Morera, J.A. Caballero Jiménez.

Tuberculosis pulmonar activa en el paciente joven: formas de presentación radiológica actual.

Rev Clin Esp, 186 (1990), pp. 206-210

Medline

[13.]

J.A. Caminero, F. Díaz, F. Rodríguez de Castro, J.L. Alonso, R.D. Daryanany, R. Carrillo, et al.

Epidemiología de la enfermedad tuberculosa en la Isla de Gran Canaria.

Med Clin (Barc), 97 (1991), pp. 8-13

[14.]

A. Domínguez, J.J. Coll, M. Fuentes, L. Salleras.

Timeliness of notification in infectious disease cases.

Public Health Reports, 107 (1992), pp. 474-476

Medline

[15.]

J.F. García Rodríguez, J. Vázquez Castro, J. De Juan Prego, M. Rodríguez Mayo, P. Sesma Sánchez, J. González Moraleja.

Epidemiología de la tuberculosis en El Ferrol.

Med Clin (Barc), 104 (1995), pp. 365-368

[16.]

J.F. García Rodríguez, A. Mariño Callejo, M.V. Lorenza García, J. De Juan Prego, J.A. Díaz Peromingo, P. Sesma Sánchez.

Oportunidades perdidas para prevenir la tuberculosis y costos derivados.

Med Cin (Barc), 109 (1997), pp. 45-48

[17.]

J. Franco, R. Blanquer, J. Flores, E. Fernández, P. Plaza, J.M. Nogueira.

Análisis del retraso diagnóstico en la tuberculosis.

Med Clin (Barc), 107 (1996), pp. 453-457

[18.]

M.A. García Ordóñez, J.D. Colmenero, A. Valencia, J. Pérez Frías, J. Sánchez González, F. Orihuela, et al.

Incidencia y espectro clínico actual de la tuberculosis en un área sanitaria metropolitana del sur de España.

Med Clin (Barc), 110 (1998), pp. 51-55

[19.]

R. Vidal, C. Mayordomo, M. Miravitlles, S. Martí, M. Torrella, J. Lorente.

Tuberculosis pulmonar y laríngea. Estudio de 26 pacientes.

Rev Clin Esp, 1196 (1996), pp. 378-380

[20.]

Grupo de Trabajo del PMIT.

Diagnóstico y tratamiento de la tuberculosis en España. Resultados del Proyecto Multicéntrico de Investigación en Tuberculosis (PMIT).

Med Clin (Barc), 116 (2001), pp. 167-173

[21.]

Grupo de Trabajo de Tuberculosis de Neumosur.

Características epidemiológicas de la enfermedad tuberculosa en el ámbito de la Sociedad de Neumólogos del Sur.

Neumosur, 7 (1995), pp. 115-127

[22.]

H. Knobel, A. Supervía, M. Salvadó, J.L. Gimeno, J.L. López Colomés, P. Saballs, et al.

Fiebre de origen desconocido en pacientes con infección por el virus de la inmunodeficiencia humana. Estudio de 100 casos.

Rev Clin Esp, 196 (1996), pp. 340-353

[23.]

T.W. Steen, G.N. Mazonde.

Pulmonaary tuberculosis in Kweneng District, Botswana: delays in diagnosis in 212 smear-positive patients.

Int J Tuberc Lung Dis, 2 (1998), pp. 627-634

Medline

[24.]

D.M. Needham, P. Godfrey-Faussett, S.D. Foster.

Barriers to tuberculosis control in urban Zambia: the economic impact and burden of patients prior to diagnosis.

Int J Tuberc Lung Dis, 2 (1998), pp. 811-817

Medline

[25.]

M.L. Pearson, J.A. Jereb, T.R. Frieden, J.T. Crawford, B.J. Davis, S.W. Dooley, et al.

Nosocomial transmission of multidrug-resistant Mycobacterium tuberculosis. A risk to patients and health care workers.

Ann Intern Med, 117 (1992), pp. 191-196

Medline

[26.]

S.F. Valway, S.B. Richards, J. Kovacovitch, R.B. Greiginger, J.T. Crawford, S.W. Dooley.

Outbreak of multidrug-resistant tuberculosis in New York State prison, 1991.

Am J Epidemiol, 140 (1994), pp. 113-122

Medline

[27.]

A. Asch, B. Leake, R. Anderson, L. Gelberg.

Why do symptomatic patients delay obtaining care for tuberculosis?.

Am J Respir Crit Care Med, 157 (1998), pp. 1244-1248

http://dx.doi.org/10.1164/ajrccm.157.4.9709071 | Medline

[28.]

J.E. Pirkis, B.R. Speed, A.P. Yung, D.R. Dunt, C.R. MacIntyre, A.J. Plant.

Time to initiation of antituberculosis treatment.

Tubercle Lung Dis, 77 (1996), pp. 401-406

[29.]

K.R. Venkatarama, E.P. Iademarco, V.J. Fraser.

Delays in the suspicion and treatment of tuberculosis among hospitalized patients.

Ann Intern Med, 130 (1999), pp. 404-411

Medline

[30.]

C.H. Greenaway, D. Menzies, A. Fanning, R. Grewal, L. Yuan, J.M. FitzGerald, et al.

Delay in diagnosis among hospitalized patients with active tuberculosis–predictors and outcomes.

Am J Respir Crit Care Med, 165 (2002), pp. 927-933

http://dx.doi.org/10.1164/ajrccm.165.7.2107040 | Medline

[31.]

Joint Tuberculosis Committee of the British Thoracic Society.

BTS guidelines. Control and prevention of tuberculosis in the United Kingdom: Code of practice 2000.

Thorax, 55 (2000), pp. 887-901

Medline

Tools

Publish in

Archivos de Bronconeumología

Free access articles

Effects of Posture on the Inspiratory and Expiratory...

10.1016/j.arbres.2024.09.011

Pulmonary Hamartoma With Rare Imaging...

10.1016/j.arbres.2024.09.015

Corrigendum to “Chronic respiratory diseases as a...

Arch Bronconeumol. 2024;60:539-40

Podcast

Respiratory Syncytial Virus Vaccination Recommendations for Adults Aged 60 Years and Older: The NeumoExperts Prevention Group Position Paper

Graphical abstract

Archivos de Bronconeumología is a member and subscribes the principles of, the Committee on Publication Ethics (COPE)
www.publicationethics.org.

Archivos de Bronconeumología follows the Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals

Indexed in:

Follow us:

Subscribe:

Subscribe to our newsletter