Analysis of diagnosis of pulmonary tuberculosis suspects in urban general health facilities

Objective To explore the influence of delays of tuber culosis(TB)diagnosis in general health facilities in order to make recommendation to improve the case detection.Methods A prospective cohort study of adult TB suspects with more than 3 weeks cough was carried out over a period of 3 months in selected general health facilities to understand their health care seeking experiences.In-depth interviews with health providers and relevant policy makers were held to explore their knowledge and attitude on TB and the TB control programme and analyze related influence factors.Results 49.2% of patients selected the district hospital as their first health service provider.61.0% of respondents were sent for X-ray and 19.1% for sputum smear test and only 4.9% were referred to TB dispensary.Qualitative data supported the findings of quantitative study and showed general health staff had insufficient knowledge on TB and TB control programme.Conclusion The general health facilities have not played a satisfactory role in complementing the TB control programme.The strategies of TB control programme are not disseminated well in the general health facilities and there is lack of the cooperation and communication between the TB control system and the general health system.