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Factors associated with the delay of diagnosis of leprosy in northeastern Colombia: a quantitative analysis.

Abstract

OBJECTIVES: To determine the average time in months between the beginning of symptoms and the diagnostic confirmation of leprosy by the health system, and to investigate factors associated with diagnostic delay.

METHODS: 249 patients older than 15 years diagnosed with leprosy between 2011 and 2015, in 20 endemic municipalities of northeastern Colombia, provided informed consent and were interviewed face to face. Clinical histories from health centers or hospitals where study participants were treated for leprosy were also reviewed.

RESULTS: The mean delay in diagnosis of leprosy was 33.5 months. 14.9% of patients showed a visible deformity or damage (disability grade 2, DG2) at the time of diagnosis. In multivariable regression analysis, 5 or more consultancies required to confirm the diagnosis and not seeking care immediately after noticing first symptoms were associated with longer diagnostic delay.

CONCLUSIONS: Our study found a significant delay in diagnosis of leprosy in northeastern Colombia, which might explain the continuously high rate of DG2 among new cases being notified in the country. Both patient- and health system-related factors were associated with longer diagnostic delay. Interventions to increase awareness of disease among the general population and timely referral to a specialized health professional are urgently needed in our study setting. This article is protected by copyright. All rights reserved.

More information

Type
Journal Article
Author
Gómez LJ
Rivera A
Vidal Y
Bilbao J
Kasang C
Parisi S
Schwienhorst-Stich E
Puchner KP