Geographical Factors in Diagnostic Delay among Multidrug Resistant Tuberculosis Patients
Abstract: Diagnostic delay is
a factor that can increase the high
burden of multi-drug resistant tuberculosis (MDR-TB). Xpert Mycobacterium
tuberculosis/Rifampicin known as Xpert is a rapid diagnostic test to detect
MDR-TB. Diagnostic delay defined the
duration between a positive result of Acid Fast Bacilli (AFB) smear and
positive result of MDR-TB by Xpert examination. This study aimed to compare the
analysis of the geographical factors in the diagnostic delay of MDR-TB patients
at Dr. Hasan Sadikin General Hospital as the top referral hospital in West Java
Indonesia.
Methods: This study was conducted in the period July−December 2016 using
cross sectional design. A total of 152 MDR-TB patient data were collected from
medical records of MDR-TB patients registered in MDR-TB clinic at Dr. Hasan
Sadikin General Hospital in the period 2015−2016. The socio-demographic characteristics were
collected and analyzed descriptively The diagnostic delay among MDR-TB patients
was analyzed by Mann Whitney test.
Results: Diagnostic delay of MDR-TB patients was 15 days in median, with
a minimal and maximal delay of 2−140 days. There was a significant difference
of diagnostic delay between patients
from Bandung with a median of 9(2-135) days and patients from outside of
Bandung with a median of 18(2-140) days, with p<0.01.
Conclusions: MDR-TB patients from outside Bandung have a longer
diagnostic delay than patient from Bandung . A further expansion of using Xpert
as a rapid diagnostic test for MDR-TB patient is needed.
Keywords: Diagnostic delay,
multi-drug resistant tuberculosis, Xpert
Author: Nunuy Nuraeni,
Hendarsyah Suryadinata, Bony Wiem Lestari
Journal Code: jpkedokterangg170162
