Abstract

Delays in the diagnosis and treatment of tuberculosis (TB) remain a significant global health problem that hinders the achievement of the WHO End TB Strategy goals. This literature review covers 26 sources from 2019–2025 and synthesizes current evidence on the duration, determinants, and consequences of delays at both the patient and health system levels in high TB burden countries, including Tajikistan. According to the included studies, the median total delay ranged from 30 to more than 100 days depending on the region. The leading patient-related factors included stigma, low awareness of disease symptoms, and structural barriers to accessing healthcare; health system-related delays were mainly associated with diagnostic errors at the primary care level, the need for out-of-pocket payments for diagnostic procedures, and insufficient availability of DOTS services. Among patients with multidrug-resistant tuberculosis (MDR-TB), delays were most pronounced and were directly associated with unfavorable treatment outcomes. Reducing delays requires comprehensive interventions, including improving public awareness, removing financial barriers, expanding the network of DOTS centers, and widespread implementation of molecular diagnostic methods.
 

Keywords

tuberculosis diagnostic delay treatment delay patient delay health system delay risk factors multidrug-resistant tuberculosis (MDR-TB) stigmatization Tajikistan Central Asia.

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