oa Using Surveillance Data To Identify Areas Of Research And Healthcare System Improvement: The Case Of Diagnosis Delay.

One of the key objectives of the surveillance of communicable disease (CDs) is the identification of areas for research and healthcare system improvement. In a recent paper published in Qatar Medical Journal (http://dx.doi.org/10.5339/qmj.2014.9) is shown the delay in diagnosis of CDs of cases reported at The Cuban Hospital (TCH) during 2012 and 2013. Examples of delay in diagnosis was for tuberculosis 61.7 days, acute hepatitis 18.5 days, typhoid fever 17 days, food poisoning 9.5 days, measles 8.0 days and meningitis 3.8 days. These are diseases that require immediate reporting because of their public health importance and some of them are highly transmissible (e.g. tuberculosis and measles). Additional evaluation of patients with tuberculosis admitted at The Cuban Hospital (many reported in Hamad General Hospital and referred to TCH because of bed crisis) from January 2013 to June 2014 (105 patients) show diagnosis delay of 49.5 days (standard deviation 51.9 years) with a maximum figure of 365 days. In patients with positive smear (highly infectious) the delay was 49.7 days (SD 53.5 days) (minimum 2 days, maximum 365 days). The delay was superior in cases with pulmonary tuberculosis (51.3 days (SD 52 days)) than in non pulmonary (36.1 days (SD 51.9 days). Delay in diagnosis of CDs is significant with regard to not only disease prognosis at the individual level but also transmission within the community. The delay could be divided in ¨patient delay and system delay¨. Patient delay refers to the time between onset of symptom and the first contact with a healthcare professional. The system delay refers to the time between this first contact to the diagnosis or confirmation of the disease. The knowledge of the two components of the delay is essential to identify actions to minimize the delay and reduce the probability of disease transmission at the community. In summary data from the surveillance of CDs suggest the need of research to identify the causes of diagnostic delay and subsequently implement actions its reduction, which will contribute to the prevention and control of CDs in Qatar.