An evaluation of diagnostic delays, patient delays, and health system delays in refugees diagnosed with tuberculosis: The case of the pandemic.

Introduction: This study aimed to compare diagnostic delay (Patient delay and health system delay) and treatment problems of tuberculosis among refugees during the coronavirus disease-2019 pandemic and determine access to healthcare and affecting factors.

Materials and methods: This cross-sectional study involved 62 patients who presented to the tuberculosis clinic and were diagnosed between 2019 and 2021.

Result: Among the participants, 45.2% were refugees. While 64.3% of the refugees reported that they experienced fear and unwillingness to present to a health institution due to pandemic conditions, this frequency was 52.9% among Turkish citizens. Mean patient delay was 37.29 days among the refugees and 26.74 days among the Turkish citizens. A significant difference was found between patient delay and health system delay times in the groups according to citizenship. Patient delay was statistically significant in the refugee group according to educational status. A negative correlation was found between the mean knowledge total score and diagnostic delay. Four Turkish participants and six refugees died.

Conclusions: This study was the first to demonstrate the diagnostic experienced by refugees. A significant difference was found between patient delay and health system delay times in groups according to citizenship. Patient delay was statistically significant in the refugee group according to educational status. A negative correlation was found between the mean knowledge total score and diagnostic delay. As a result, it is crucial to prevent diagnostic delays in refugee and immigrant healthcare and ensure the resilience of tuberculosis management during the pandemic.