Preston, L. orcid.org/0000-0001-7477-4517, Thompson, A., Baxter, S. et al. (5 more authors) (2025) A rapid review of the causes of diagnostic and treatment delays for tuberculosis in low burden countries. Journal of Public Health. ISSN: 1741-3842
Abstract
Background
Delays in diagnosing and treating tuberculosis have significant implications. We undertook a rapid review to explore factors associated with delays at all stages of the diagnostic and treatment pathways in low burden settings.
Methods
We searched databases (Embase, Medline, CENTRAL, Cinahl, PubMed, Cochrane Database of Systematic Reviews, and Web of Science) for qualitative and quantitative evidence (2010-2025) from countries with low tuberculosis burden (incidence rate < 40/100,000 in 2020). Included studies were assessed on their robustness and relevance. Due to the rapid review design, we did not conduct formal quality appraisal.
Results
The review included three reviews, five qualitative studies, 18 cohort studies and 13 cross sectional studies (n=41) with varying robustness and relevance. By synthesizing data using a patient pathway, we uncovered patient- and healthcare-related factors that contribute to delays such as medical history, health behaviours, level of patient and physician suspicion of TB, service location (primary care) and timing of TB testing. Having extrapulmonary TB was associated with greater total delay.
Conclusions
We have identified patient and health service factors that are consistently associated with patient, diagnostic, and total delay from TB symptom onset to initiation of treatment in low burden settings. Factors amenable to change should be the focus of public health interventions aimed at reducing TB diagnostic delay.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2025. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: | Diagnosis |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 13 Aug 2025 09:38 |
Last Modified: | 25 Sep 2025 07:57 |
Status: | Published online |
Publisher: | Oxford University Press |
Refereed: | Yes |
Identification Number: | 10.1093/pubmed/fdaf106 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:230220 |