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Epidemiology and policy
P1-197 Role of health system in determine of delay to diagnosis, treatment and outcomes of tuberculosis in west Azerbaijan province, Iran: active vs passive primary healthcare in rural to urban setting
  1. G Kolifarhood1,
  2. S Salarilak2,3,
  3. S Dastgiri4,
  4. N Khosravi1,
  5. B Neamati3,
  6. P Mikaili3,
  7. D Khorasani3,
  8. A N nejad3,
  9. Y Mohammadpour3,
  10. R Gareaghaji3
  1. 1Zanjan University of Medical Science, Zanjan, Iran
  2. 2Islamic Azad University of Iran, Tabriz Branch, Medical Faculty, Tabriz, Iran
  3. 3Urmia University of Medical Science, Urmia, Iran
  4. 4Tabriz University of Medical Science, East Azerbaijan, Iran

Abstract

Objective Comparison of active vs passive primary healthcare function in rural with urban setting at determine of delay to diagnosis and treatment of tuberculosis and its outcomes in West Azerbaijan province, Iran, at 2004–2009.

Material and Methods In this perspective study we used years TB new cases data that have been recorded by TB management center in West Azerbaijan province. Patient and health system delay were determined as number of days between onset of symptoms to diagnosis and diagnosis to start of treatment respectively.

Results At comparison of domicile, both of patient and health delay mean days were more in urban patients (respectively 241 vs 133, p value=0.02 and 11 vs 7, p value=0.006). In rural patients, females at comparison of males had more mean total time delays (163 vs 115, p value=0.01). Despite of higher mean of total delays in extra pulmonary to pulmonary at both of domicile (respectively urban 278 vs 232 and rural 197 vs 97), there was significantly difference in rural regions (p value=0.0001). Default rate in rural regions was less than urban settings (respectively 3.53% vs 6.08%) and whereas success rate was more than it (respectively 81% vs 79%).

Conclusion At regard to health system policy in Iran that primary healthcare for tuberculosis in rural regions is active whereas urban setting is passive, it seems there is urgent need to change of policy in case finding and case holding of patients in urban area to decrease time delays and increase positive outcomes.

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