Diagnostic delays in Middle East respiratory syndrome coronavirus patients and health systems
Identifieur interne : 000618 ( Main/Exploration ); précédent : 000617; suivant : 000619Diagnostic delays in Middle East respiratory syndrome coronavirus patients and health systems
Auteurs : Anwar E. Ahmed [Arabie saoudite]Source :
- Journal of Infection and Public Health [ 1876-0341 ] ; 2019.
Descripteurs français
- KwdFr :
- MESH :
- diagnostic : Infections à coronavirus.
- isolement et purification : Coronavirus du syndrome respiratoire du Moyen-Orient.
- Adolescent, Adulte, Adulte d'âge moyen, Enfant, Femelle, Humains, Jeune adulte, Mâle, Retard de diagnostic, Sujet âgé, Sujet âgé de 80 ans ou plus.
English descriptors
- KwdEn :
- MESH :
- diagnosis : Coronavirus Infections.
- isolation & purification : Middle East Respiratory Syndrome Coronavirus.
- statistics & numerical data : Delayed Diagnosis.
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Female, Humans, Male, Middle Aged, Young Adult.
Abstract
Although Middle East respiratory syndrome coronavirus (MERS-CoV) diagnostic delays remain a major challenge in health systems, the source of delays has not been recognized in the literature. The aim of this study is to quantify patient and health-system delays and to identify their associated factors.
The study of 266 patients was based on public source data from the World Health Organization (WHO) (January 2, 2017–May 16, 2018). The diagnostic delays, patient delays, and health-system delays were calculated and modelled using a Poisson regression analysis.
In 266 MERS-CoV patients reported during the study period, the median diagnostic delays, patient delays, and health-system delays were 5 days (interquartile [IQR] range: 3–8 days), 4 days (IQR range: 2–7 days), and 2 days (IQR range: 1–2 days), respectively. Both patient delay (r = 0.894, P = 0.001) and health-system delay (r = 0.163, P = 0.025) were positively correlated with diagnostic delay. Older age was associated with longer health-system delay (adjusted relative ratios (aRR), 1.011; 95% confidence intervals (CI), 1.004–1.017). Diagnostic delay (aRR, 1.137; 95% CI, 1.006–1.285) and health-system delays (aRR, 1.217; 95% CI, 1.003–1.476) were significantly longer in patients who died.
Delays in MERS-CoV diagnosis exist and may be attributable to patient delay and health-system delay as both were significantly correlated with longer diagnosis delay. Early MERS-CoV diagnosis may require more sensitive risk assessment tools to reduce avoidable delays, specifically those related to patients and health system.
Url:
DOI: 10.1016/j.jiph.2019.04.002
PubMed: 31006635
PubMed Central: 7102677
Affiliations:
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Le document en format XML
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Ahmed</name><affiliation wicri:level="1"><nlm:aff id="aff0005">College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff0010">King Abdullah International Medical Research Center, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>King Abdullah International Medical Research Center, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff0015">Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Ministry of National Guard-Health Affairs, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Infection and Public Health</title><idno type="ISSN">1876-0341</idno><idno type="eISSN">1876-035X</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Child</term><term>Coronavirus Infections (diagnosis)</term><term>Delayed Diagnosis (statistics & numerical data)</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Middle East Respiratory Syndrome Coronavirus (isolation & purification)</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Coronavirus du syndrome respiratoire du Moyen-Orient (isolement et purification)</term><term>Enfant</term><term>Femelle</term><term>Humains</term><term>Infections à coronavirus (diagnostic)</term><term>Jeune adulte</term><term>Mâle</term><term>Retard de diagnostic ()</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à coronavirus</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Middle East Respiratory Syndrome Coronavirus</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Coronavirus du syndrome respiratoire du Moyen-Orient</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Delayed Diagnosis</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Child</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Enfant</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Retard de diagnostic</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Although Middle East respiratory syndrome coronavirus (MERS-CoV) diagnostic delays remain a major challenge in health systems, the source of delays has not been recognized in the literature. The aim of this study is to quantify patient and health-system delays and to identify their associated factors.</p></sec><sec><title>Methods</title><p>The study of 266 patients was based on public source data from the World Health Organization (WHO) (January 2, 2017–May 16, 2018). The diagnostic delays, patient delays, and health-system delays were calculated and modelled using a Poisson regression analysis.</p></sec><sec><title>Results</title><p>In 266 MERS-CoV patients reported during the study period, the median diagnostic delays, patient delays, and health-system delays were 5 days (interquartile [IQR] range: 3–8 days), 4 days (IQR range: 2–7 days), and 2 days (IQR range: 1–2 days), respectively. Both patient delay (r = 0.894, P = 0.001) and health-system delay (r = 0.163, P = 0.025) were positively correlated with diagnostic delay. Older age was associated with longer health-system delay (adjusted relative ratios (aRR), 1.011; 95% confidence intervals (CI), 1.004–1.017). Diagnostic delay (aRR, 1.137; 95% CI, 1.006–1.285) and health-system delays (aRR, 1.217; 95% CI, 1.003–1.476) were significantly longer in patients who died.</p></sec><sec><title>Conclusion</title><p>Delays in MERS-CoV diagnosis exist and may be attributable to patient delay and health-system delay as both were significantly correlated with longer diagnosis delay. Early MERS-CoV diagnosis may require more sensitive risk assessment tools to reduce avoidable delays, specifically those related to patients and health system.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Memish, Z A" uniqKey="Memish Z">Z.A. Memish</name></author><author><name sortKey="Cotten, M" uniqKey="Cotten M">M. Cotten</name></author><author><name sortKey="Watson, S J" uniqKey="Watson S">S.J. Watson</name></author><author><name sortKey="Kellam, P" uniqKey="Kellam P">P. Kellam</name></author><author><name sortKey="Zumla, A" uniqKey="Zumla A">A. Zumla</name></author><author><name sortKey="Alhakeem, R F" uniqKey="Alhakeem R">R.F. Alhakeem</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ahmed, A E" uniqKey="Ahmed A">A.E. Ahmed</name></author><author><name sortKey="Alshukairi, A N" uniqKey="Alshukairi A">A.N. Alshukairi</name></author><author><name sortKey="Al Jahdali, H" uniqKey="Al Jahdali H">H. Al-Jahdali</name></author><author><name sortKey="Alaqeel, M" uniqKey="Alaqeel M">M. Alaqeel</name></author><author><name sortKey="Siddiq, S S" uniqKey="Siddiq S">S.S. Siddiq</name></author><author><name sortKey="Alsaab, H A" uniqKey="Alsaab H">H.A. Alsaab</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ahmed, A E" uniqKey="Ahmed A">A.E. Ahmed</name></author><author><name sortKey="Al Jahdali, H" uniqKey="Al Jahdali H">H. Al-Jahdali</name></author><author><name sortKey="Alshukairi, A N" uniqKey="Alshukairi A">A.N. Alshukairi</name></author><author><name sortKey="Alaqeel, M" uniqKey="Alaqeel M">M. Alaqeel</name></author><author><name sortKey="Siddiq, S S" uniqKey="Siddiq S">S.S. Siddiq</name></author><author><name sortKey="Alsaab, H" uniqKey="Alsaab H">H. Alsaab</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ahmed, A E" uniqKey="Ahmed A">A.E. Ahmed</name></author><author><name sortKey="Al Jahdali, H" uniqKey="Al Jahdali H">H. Al-Jahdali</name></author><author><name sortKey="Alaqeel, M" uniqKey="Alaqeel M">M. Alaqeel</name></author><author><name sortKey="Siddiq, S S" uniqKey="Siddiq S">S.S. Siddiq</name></author><author><name sortKey="Alsaab, H A" uniqKey="Alsaab H">H.A. Alsaab</name></author><author><name sortKey="Sakr, E A" uniqKey="Sakr E">E.A. Sakr</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ahmed, A E" uniqKey="Ahmed A">A.E. Ahmed</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Park, H Y" uniqKey="Park H">H.Y. Park</name></author><author><name sortKey="Lee, E J" uniqKey="Lee E">E.J. Lee</name></author><author><name sortKey="Ryu, Y A" uniqKey="Ryu Y">Y.A. Ryu</name></author><author><name sortKey="Kim, Y" uniqKey="Kim Y">Y. Kim</name></author><author><name sortKey="Kim, H" uniqKey="Kim H">H. Kim</name></author><author><name sortKey="Lee, H" uniqKey="Lee H">H. Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ahmed, A E" uniqKey="Ahmed A">A.E. Ahmed</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ahmed, A E" uniqKey="Ahmed A">A.E. Ahmed</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bawazir, A" uniqKey="Bawazir A">A. Bawazir</name></author><author><name sortKey="Al Mazroo, E" uniqKey="Al Mazroo E">E. Al-Mazroo</name></author><author><name sortKey="Jradi, H" uniqKey="Jradi H">H. Jradi</name></author><author><name sortKey="Ahmed, A" uniqKey="Ahmed A">A. Ahmed</name></author><author><name sortKey="Badri, M" uniqKey="Badri M">M. Badri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Al Mohaissen, M" uniqKey="Al Mohaissen M">M. Al Mohaissen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alsahafi, A J" uniqKey="Alsahafi A">A.J. Alsahafi</name></author><author><name sortKey="Cheng, A C" uniqKey="Cheng A">A.C. Cheng</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Al Ghamdi, M" uniqKey="Al Ghamdi M">M. Al Ghamdi</name></author><author><name sortKey="Alghamdi, K M" uniqKey="Alghamdi K">K.M. Alghamdi</name></author><author><name sortKey="Ghandoora, Y" uniqKey="Ghandoora Y">Y. Ghandoora</name></author><author><name sortKey="Alzahrani, A" uniqKey="Alzahrani A">A. Alzahrani</name></author><author><name sortKey="Salah, F" uniqKey="Salah F">F. Salah</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Omrani, A S" uniqKey="Omrani A">A.S. Omrani</name></author><author><name sortKey="Shalhoub, S" uniqKey="Shalhoub S">S. Shalhoub</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Arabie saoudite</li></country></list><tree><country name="Arabie saoudite"><noRegion><name sortKey="Ahmed, Anwar E" sort="Ahmed, Anwar E" uniqKey="Ahmed A" first="Anwar E." last="Ahmed">Anwar E. Ahmed</name></noRegion><name sortKey="Ahmed, Anwar E" sort="Ahmed, Anwar E" uniqKey="Ahmed A" first="Anwar E." last="Ahmed">Anwar E. Ahmed</name><name sortKey="Ahmed, Anwar E" sort="Ahmed, Anwar E" uniqKey="Ahmed A" first="Anwar E." last="Ahmed">Anwar E. Ahmed</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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