Francesco Di Gennaro, Sergio Cotugno, Giacomo Guido, Francesco Cavallin, Mariantonietta Pisaturo, Lorenzo Onorato, Federica Zimmerhofer, Luca Pipitò, Giuseppina De Iaco, Giuseppe Bruno, Massimo Fasano, Agostina Pontarelli, Annarita Botta, Tiziana Iacovazzi, Rossana Lattanzio, Virginia Di Bari, Gianfranco Panico, Raffaella Libertone, Caterina Monari, Alessia Musto, Mariangela Niglio, Federica De Gregorio, Loredana Alessio, Gina Gualano, Salvatore Minniti, Giovanni Battista Buccoliero, Teresa Santantonio, Sergio Lo Caputo, Sergio Carbonara, Antonio Cascio, Roberto Parrella, Fabrizio Palmieri, Nicola Coppola, Annalisa Saracino
{"title":"Disparities in Tuberculosis Diagnostic Delays between Native and Migrant Populations in Italy: A Multicenter Study.","authors":"Francesco Di Gennaro, Sergio Cotugno, Giacomo Guido, Francesco Cavallin, Mariantonietta Pisaturo, Lorenzo Onorato, Federica Zimmerhofer, Luca Pipitò, Giuseppina De Iaco, Giuseppe Bruno, Massimo Fasano, Agostina Pontarelli, Annarita Botta, Tiziana Iacovazzi, Rossana Lattanzio, Virginia Di Bari, Gianfranco Panico, Raffaella Libertone, Caterina Monari, Alessia Musto, Mariangela Niglio, Federica De Gregorio, Loredana Alessio, Gina Gualano, Salvatore Minniti, Giovanni Battista Buccoliero, Teresa Santantonio, Sergio Lo Caputo, Sergio Carbonara, Antonio Cascio, Roberto Parrella, Fabrizio Palmieri, Nicola Coppola, Annalisa Saracino","doi":"10.1016/j.ijid.2024.107279","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a Global Health challenge, with diagnostic delays contributing significantly to its spread. This study investigates the differences in diagnostic delays between native and migrant TB patients in Italy, examining patient-related diagnostic delay (PDD), health system-related diagnostic delay (HDD), and total diagnostic delay (TDD).</p><p><strong>Methods: </strong>We conducted a retrospective, multicenter, cross-sectional study of TB cases in ten Italian hospitals from 2018 to 2023. We compared PDD, HDD, and TDD between native and migrant populations. Socio-demographic data and clinical histories were analyzed to identify factors contributing to diagnostic delays.</p><p><strong>Results: </strong>We included 669 TB patients (390 migrants and 279 natives). Migrants experienced significantly longer PDD (median 90 vs. 10 days, p<0.0001) but shorter HDD (median 5 vs. 40 days, p<0.0001) compared to natives, resulting in a longer TDD (median 96 vs. 65 days, p<0.0001). Furthermore, migrants had higher Timika scores, longer sputum conversion times, and were more frequently lost to follow-up.</p><p><strong>Conclusions: </strong>Migrants face longer PDD, emphasizing substantial barriers to healthcare access. Natives experience longer HDD, reflecting neglect of TB in low-endemic regions. Future research should focus on the impact of social determinants and training for healthcare providers on TB diagnosis and develop strategies to reduce diagnostic delays.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ijid.2024.107279","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Tuberculosis (TB) remains a Global Health challenge, with diagnostic delays contributing significantly to its spread. This study investigates the differences in diagnostic delays between native and migrant TB patients in Italy, examining patient-related diagnostic delay (PDD), health system-related diagnostic delay (HDD), and total diagnostic delay (TDD).
Methods: We conducted a retrospective, multicenter, cross-sectional study of TB cases in ten Italian hospitals from 2018 to 2023. We compared PDD, HDD, and TDD between native and migrant populations. Socio-demographic data and clinical histories were analyzed to identify factors contributing to diagnostic delays.
Results: We included 669 TB patients (390 migrants and 279 natives). Migrants experienced significantly longer PDD (median 90 vs. 10 days, p<0.0001) but shorter HDD (median 5 vs. 40 days, p<0.0001) compared to natives, resulting in a longer TDD (median 96 vs. 65 days, p<0.0001). Furthermore, migrants had higher Timika scores, longer sputum conversion times, and were more frequently lost to follow-up.
Conclusions: Migrants face longer PDD, emphasizing substantial barriers to healthcare access. Natives experience longer HDD, reflecting neglect of TB in low-endemic regions. Future research should focus on the impact of social determinants and training for healthcare providers on TB diagnosis and develop strategies to reduce diagnostic delays.
期刊介绍：
International Journal of Infectious Diseases (IJID)
Publisher: International Society for Infectious Diseases
Publication Frequency: Monthly
Type: Peer-reviewed, Open Access
Scope:
Publishes original clinical and laboratory-based research.
Reports clinical trials, reviews, and some case reports.
Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases.
Emphasizes diseases common in under-resourced countries.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
