Delay in the diagnosis of pulmonary tuberculosis, London, 1998-2000: analysis of surveillance data

Noted cases of tuberculosis each year have doubled in London since 1987. In 2000, 12.9 cases per 100 000 population in England and Wales were recorded compared with 40.3 cases in London.1 A delay in the diagnosis of tuberculosis increases the risk of poor clinical outcome—including death and transmission of tuberculosis. 2 3 Understanding which factors influence this delay is crucial for controlling tuberculosis. Only one small study has previously investigated delays in the diagnosis of pulmonary tuberculosis in the United Kingdom.4 Using surveillance data from London, we estimated the delays in diagnosis of tuberculosis and investigated the factors independently associated with delays. We analysed surveillance data collected by doctors (1999-2000) and an anonymised national survey (1998) for cases of tuberculosis in London from 1998 to 2000. We calculated the delay in …