In conclusion, the present study suggests that our
patients with smear-positive pulmonary tuberculosis had
several delays from the onset of symptoms to initiation of
treatment. Because untreated smear-positive patients are
the main sources of infection, delays in the diagnosis and
treatment of these patients increase the risk of disease
transmission in the community. These delays are also
associated with a prolonged period of infectivity for
medical personnel. According to our data, doctor delay
was more significant than patient delay, and institutional
delay was the most important component of doctor
delay. The low index of tuberculosis, underutilized chest X-ray and sputum smear examinations among physi-
cians, and health care system and laboratory delays were
the most common causes of doctor delay. Several efforts
should be made to reduce these delays for the sake of
tuberculosis control. Physicians and the public should be
educated about tuberculosis. Health care system and lab-
oratory delays should be minimized. These efforts can
reduce delays in pulmonary tuberculosis treatment. We
conclude that delays are important reasons for the
increased period of infectivity, and that decreasing these
delays will help tuberculosis control.