SUMMARY
SETTING: Nationwide tuberculosis (TB) registry in Japan, 1987-2002.
OBJECTIVE: To clarify the trends of patient's delay (PD), doctor's delay (DD) and total delay (TD), their relation and factors associated with the delays.
DESIGN: Longitudinal study on trends in delays. Among patients with symptomatic smear-positive pulmonary TB, those with long PD (>2 months), DD (>1 month) and TD (>3 months) were analysed.
RESULTS: Long PD rates increased until around 1997, whereas long DD rates decreased markedly from 1995 to 1999. Long TD rates increased until 1997, and de-creased slightly thereafter. Men aged 30-59 years had higher rates of long PD, and the long PD rates increased through the 16-year observation period. Day labourers receiving or applying for welfare benefit had the highesi rate of long TD, 46.5% during 1995-2002. Teachers and medical doctors showed the greatest increase in long TD rates through the period.
CONCLUSION: Long TD was influenced more by PD than DD, and showed an upward trend. However, the long TD rate has declined slightly owing to the recent re- duction in long DD. The reduction in DD since 1995 oc-curred immediately after the introduction of new technology in bacteriological examinations.
KEY WORDS: tuberculosis; case finding; delay; factor; Japan