Prescribed and self-medication use increase delays in diagnosis of tuberculosis in the country of Georgia.

SETTING: Georgia has a high burden of tuberculosis (TB), including multidrug-resistant TB. Enhancing early diagnosis of TB is a priority to reduce transmission. OBJECTIVE: To quantify delays in TB diagnosis and identify risk factors for delay in the country of Georgia. DESIGN: In a cross-sectional study, persons with newly diagnosed, culture-confirmed pulmonary TB were interviewed within 2 months of diagnosis and medical and laboratory records were abstracted. RESULTS: Among 247 persons enrolled, the mean and median total TB diagnostic delay was respectively 89.9 and 59.5 days. The mean and median patient delay was 56.2 and 23.5 days, while health care system delay was 33.7 and 14.0 days. In multivariable analysis, receipt of a medication prior to TB diagnosis was associated with increased overall diagnostic delay (adjusted odds ratio [aOR] 2.28, 95%CI 1.09-4.79); antibiotic use prior to diagnosis increased the risk of prolonged health care delay (aOR 4.16, 95%CI 1.97-8.79). TB cases who had increased patient-related diagnostic delay were less likely to have prolonged health care diagnostic delay (aOR 0.38, 95%CI 0.19-0.74). CONCLUSION: Prolonged delays in detecting TB are common in Georgia. Interventions addressing the misuse of antibiotics and targeting groups at risk for prolonged delay are warranted to reduce diagnostic delays and enhance TB control.

[For periodization of history of fight against TB in Georgia].

Evolution of TB programs indicates the importance of analysis of existing experience and reasons of failure in planning of TB strategy for future. In spite of existing scientific researches in the field of history of fight against TB in Georgia, it turned out that the question is not mastered perfectly, various periods are not sorted out and the comparative analysis is not made. On account of this, a request was raised to elaborate a new periodization. The aim of our research is to work out a new variant of periodization of history of fight against TB in Georgia. Epidemic, literary and the official statistical data were worked out by the methods of historical analysis and standardization. According to the research, it turned out that the correlation exists between social -political state and the spreading of TB, which was reflected in our "step" pattern. It means to serve as criteria of spreading of tuberculosis and TB strategy. Concerning these criteria a new variant of periodization was elaborated and the separate stages were compared. It gives us opportunity to determine effective methods and measures and they should be envisaged in the condition of realisation DOTS strategy in Georgia.