SETTING: Two closed camps in Hong Kong for Vietnamese refugees. OBJECTIVE: To determine the referral times by clinicians (doctor's delay) of cases of tuberculosis (TB) from refugee camp clinics to the hospital/chest clinic. DESIGN: Retrospective case-note study of 97 Vietnamese patients receiving treatment for tuberculosis. RESULTS: The sites of TB were pulmonary (n = 61), glandular (n = 15), pleural effusion (n = 15), and other (n = 6). The median referral time was 18 days (range 0417). Median consultations numbered three (range 116). Fifty-three (54.6%) patients were prescribed antibiotics. Thirty-nine (40%) patients were referred within 10 days; of these, 18 were referred the same day. These 39 patients were less likely to have received antibiotics (9/39 [23.1%] vs 44/58 [75.9%], relative risk [RR] 0.3 95% confidence interval [CI] 0.17-0.55), but were equally likely to have been physically examined (RR 0.66, 95%CI 0.39-1.1). Sixteen (16.5%) patients were referred after 90 days. They attended the clinic more often (median attendances 6.5 vs 3, P = 0.0002), and were prescribed more antibiotic courses (mean antibiotic prescriptions 1.6 vs 0.7, P = 0.03). CONCLUSION: Referral times by these clinicians varied widely, with long delays for approximately 60% of patients. Guidelines pertinent to primary care clinicians are needed to heighten their awareness of tuberculosis to prevent referral delays and subsequent TB treatment.

Vietnam Delay tuberculosis Refugees Hong Kong

Vietnam primary medical care refugee Life Tables human risk assessment Refugees middle aged antibiotic agent priority journal Time Factors Humans lung tuberculosis Adolescent Antitubercular Agents male female Viet Nam patient referral tuberculosis Child, Preschool Referral and Consultation Physicians, Family prevalence Article Retrospective Studies major clinical study adult pleura effusion Practice Guidelines tuberculosis control Hong Kong Child