Short summary

Delay in tuberculosis diagnosis and treatment contributes to increased disease severity and active disease transmission. Previously reported risk factors for delay varies across geographical and cultural settings and need to be investigated further in low-incidence settings. This study aimed to investigate delay in tuberculosis diagnosis and patient-reported reasons for delay in Denmark.

Rationale

Risk factors for diagnostic delay are heterogeneous, there is a need for setting specific data to improve national TB programs.

Diagnostic delay has not been studied sufficiently in low-incidence countries like Denmark.

To our knowledge only few studies have reported some data on TB diagnostic delay in Denmark, and patients' self-reported reasons for delay have not yet been reported.

Description of the cohort

We conducted a multicenter prospective cohort study with consecutive enrolment of adult patients newly diagnosed with TB in Denmark from September 2019 to March 2023.

The inclusion criteria are:

age ≥ 18 years old and diagnosed with TB.

TB diagnosis will be defined according to the European Centre for Disease Prevention and Control (ECDC) case definition for TB.

Eligible individuals will be enrolled from the following TB centers: the Region of Southern Denmark (the Department of Infectious and Respiratory Diseases at Odense University Hospital and at Hospital South West Jutland), the Capital Region of Denmark (the Department of Infectious Diseases at Hvidovre Hospital, the Department of Infectious and Respiratory Diseases at Gentofte Hospital and New North Zealand Hospital), the Central Denmark Region (the Department of Infectious and Respiratory Diseases at Aarhus University Hospital).

Data and biological material

Upon enrollment, patients will be interviewed about their TB related history and events that led to diagnosis.

The interviews include face-to-face and telephone interviews using a structured questionnaire developed in consultation with experts on infectious diseases and after searching the literature for similar studies.

Based on the questionnaire we obtaine information on: Date of symptom onset, number and places of healthcare contacts prior to diagnosis, patient reported reasons for PD (if >7 days after symptom onset), and if patients had received antibiotics prior to diagnosis. We have twelve predefined categories for patient reported reasons for delay in seeking healthcare.

The clinical data will be retrieved from the patient's medical record.