[Reasons for delayed diagnosis of pulmonary tuberculosis].

Abstract

100 patients at first treatment were investigated according to a complete questionnaire for explaining the causes of tardy diagnosis in pulmonary tuberculosis. The roles of the disease, patient and physician in this delay were followed. The insidious or atypical onset of the disease in 82% of these patients explains the long interval (107.2 days on the average) elapsed between the appearance of the first symptoms and the diagnosis determination. As a consequence of low cultural level, many patients cannot give a correct interpretation of the symptomatology and they seek the physician's help after 69.1 days (on the average) from the appearance of the symptoms. The medical causes are numerous and can be rapidly cured. In the dispensary of general medicine, 55% patients were examined only clinically, 45% clinically and radiologically but only 7% were subjected to the bacteriologic examination for bK and 4% were sent to the TB wards for consultation. As the registration of the patient, his admission into the hospital and the tuberculostatic treatment depend on the bK presence in sputum--sometimes waiting for the result of the culture tests--the average interval between consultation and admission is of about 34.7 days. On admission, high average values were registered: cavities of 4.2 cm in diameter, lesions of 2.8 points and bacteriologically 44 bacilli/100 fields. For improving this situation the following recommendations are made: increase of the health education on TB activity in the population, continuous education of the general practitioners in the TB diagnosis methods, use of the radiologic examination together with the bacteriologic one and the biological tests for the early detection of the pulmonary tuberculosis.