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Objectives/background: Pulmonary tuberculosis continues to increase due to late patient presentation for diagnosis at health facilities. The objectives of this study were to assess delay in diagnosis of pulmonary tuberculosis and identify reasons for the delay. Methods: One thousand four hundred and eight seven presumptive tuberculosis cases participated in this cross-sectional study. Participants age ranged from 15 years and above; 661 (44.5%) were males and 826 (55.5%) were females. Diagnosis of pulmonary tuberculosis was based on National Tuberculosis Guidelines; using smear microscopy (ZN technique) and grading according to recent WHO policy where smears with>1 acid fast bacilli/100 high power fields was considered positive. Questionnaires were administered to patients to identify reasons for delay in diagnosing pulmonary tuberculosis. Results: The main symptoms of pulmonary tuberculosis the patients presented with were cough (86%), fever (76%), night sweats (63.5%), weight loss (60.5%), and fatigue (56%). The prevalence of smear positive of pulmonary tuberculosis was 12.3%. Majority of presumptive TB cases 1,118 (75.2%) delayed diagnosis more 30 days following onset of symptoms. Only 369 (24.8%) presumptive tuberculosis cases sought diagnosis within 30 days of onset of symptoms. The longest patient delay was 186 days and minimum period of days before diagnosis was 14 days. The main reasons for delay in seeking early diagnosis were the fact that respondents thought the cause of pulmonary tuberculosis could not be diagnosed in a health facility (41.5%), poor knowledge of what pulmonary tuberculosis is (20.5%) and belief in the efficacy prayer house healing (13.6%). Conclusion: There was a considerably long patient delay in diagnosing pulmonary tuberculosis. The reasons for the delay include ignorance and misconception on the part of the patients and their belief in the efficacy of prayer house healing. Reducing the delay will require health education on the importance of early diagnosis of pulmonary tuberculosis following onset of symptoms.

Submitted by Bruno Gonçalves (bgoncalves@fp.ul.pt) on 2012-06-11T10:39:32Z No. of bitstreams: 1 Depressão_Meia-idade.pdf: 4428845 bytes, checksum: 0fde388f8577159eb94f4b1c5fcd20bb (MD5) Made available in DSpace on 2012-06-11T10:52:27Z (GMT). No. of bitstreams: 1 Depressão_Meia-idade.pdf: 4428845 bytes, checksum: 0fde388f8577159eb94f4b1c5fcd20bb (MD5) Previous issue date: 2005

É estudada a prevalência de perturbações depressivas numa amostra de mulheres com idades compreendidas entre os 35 e os 65 anos, utentes dos cuidados de saúde primários. Todas as mulheres (n = 179) responderam à versão portuguesa da Center for Epidemiologic Studies Depression Scale (CES‑D) e, as que aceitaram (n = 127), participaram numa entrevista clínica estruturada adaptada do módulo de avaliação das perturbações do humor da Structured Clinical Interwiew for DSM‑IV Axis I Disorders (SCID‑I), a fim de avaliar a presença de várias formas de depressão segundo os critérios do DSM‑IV. Verificou‑se que 13% destas mulheres satisfaziam os critérios para o diagnóstico de episódio depressivo major, 19% satisfaziam os critérios para perturbação distímica e 5,5% satisfaziam os critérios propostos para episódio depressivo minor. São analisadas as relações da idade, nível de instrução, estatuto conjugal, ter filhos, ter filhos em casa, ter filhos a cargo e outras variáveis sociodemográficas com a ocorrência de perturbações depressivas. This study is based on the data collected in an investigation regarding Primary Health Care patients. The prevalence of depressive disorders is studied in a sample of women with ages ranging between 35 and 65 years. All women (n = 179) responded to the Center for Epidemiologic Studies Depression Scale (CES‑D), and 127 agreed to participate in a structured clinical interview adapted from the evaluation of mood disorders section of the Structured Clinical Interwiew for DSM‑IV Axis I Disorders (SCID‑I) in order to evaluate the presence of various forms of depression according to the DSM‑IV criteria. It was verified that 13% of these women met the criteria for the diagnosis of a Major Depressive Episode, 19% met the criteria for Dysthymic Disorder and 5,5% met the criteria proposed for a Minor Depressive Episode. The relation of age, education level, marital status, work for pay, having children, children at home, dependent children and other socio‑demographic variables with the rate of depressive disorders is studied.

The CES-D is a depression scale designed to measure depressive symptomatology in the general population. The authors developed a Portuguese version of this scale. This article presents the results of the three studies carried out with this version. These results support the reliability and the validity of the scale. The CES-D proved to be sensitive to variations in the intensity of depressive symptomatology and can be used in epidemiological studies or as a screening instrument in a clinical setting. Sex does have some influence on the values of sensitivity and specificity but the educational level has a greater influence on scores: subjects with a lower education level tend to obtain higher scores with the same level of depressive symptomatology as evaluated by the clinical interview.

Apresentam-se os resultados respeitantes a uma entrevista semi-estruturada para crianças com Síndrome Nefrótico e com Doença Celíaca construída no âmbito de um estudo mais alargado dirigido para o impacto destas doenças na infância. Exploram-se, em particular, as respostas a questões que avaliam a percepção da criança relativamente ao modo como se sente tratada pelos outros em função da doença. Os participantes têm idades compreendidas entre os 6 e os 10 anos e estão distribuídos por dois grupos: G1 - Síndrome Nefrótico (n=27), G2 - Doença Celíaca (n=27). Verifica-se que as crianças não diferem de forma importante no modo como se sentem tratadas pelos outros. No entanto, tendem a manifestar uma percepção diferencial em conteúdos particulares quando estão em causa características específicas da relação que a mãe, o pai e os irmãos estabelecem com elas. A semi-structured interview to children with Nephrotic Syndrome and children with Celiac Disease was developed in the context of a larger study that addressed the impact of these diseases in infancy. Answers to specific questions that evaluate the perception of the way the children feel others treat them, in function of disease, were analyzed. The participants (6 to 10 years old) were distributed in two groups: G1 - Nephrotic Syndrome (n=27), G2 - Celiac Disease (n=27). Results show that, in general, the two groups do not differ importantly. However, they present a differential perception in some domains concerning specific characteristics of the relationship between mother, father and siblings with the child.