Time delays in the diagnosis and treatment of malaria in non-endemic countries: a systematic review

Bastaki, Hamad, Carter, Jessica, Marston, Louise, Cassell, Jackie and Rait, Greta (2018) Time delays in the diagnosis and treatment of malaria in non-endemic countries: a systematic review. Travel Medicine and Infectious Disease, 21. pp. 21-27. ISSN 1477-8939

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Abstract

Background
Delays in diagnosis and treatment for malaria are associated with an increased risk for severe disease and mortality. Identifying the extent of patient and health system delay can provide a benchmark against which interventions to reduce delays can be measured.

Methods
We performed an electronic search in PubMed, EMBASE, Web of Science and LILACS for studies reporting time to diagnosis and treatment after return from travel, onset of symptoms and seeking healthcare in non-endemic countries. Additionally, theses, conference proceedings and nationally reported surveillance data were also searched for information on time delays. There were no language restrictions and all the studies were assessed for methodological quality.

Results
Data from 69 papers out of 1719 identified records published between 2005 and 2017 were extracted; our findings show that median diagnosis delays of four or more days are common and patient delays accounted for a large proportion of diagnostic delay. There were limited data available on medical diagnostic delay.

Conclusion
Patient delays accounted for a large proportion of the overall diagnostic delay; however the retrospective nature of the studies could have overestimated patient delay since previous healthcare contacts were not included. Additionally, the high frequency of studies reporting a clinically significant delay is a major concern.

Item Type: Article
Keywords: infectious disease malaria Primary care
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
Subjects: R Medicine
Depositing User: Jackie Cassell
Date Deposited: 26 Jan 2018 15:05
Last Modified: 03 Jul 2018 11:46
URI: http://sro.sussex.ac.uk/id/eprint/73161

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