{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T18:33:54Z","timestamp":1784745234897,"version":"3.55.0"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although timely tuberculosis (TB) diagnosis and treatment are essential to TB elimination, care delays remain a challenge. Understanding factors associated with delayed TB diagnosis and treatment may inform interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The TB Sentinel Research Network of the International epidemiology Databases to Evaluate AIDS (IeDEA) is a prospective study of people aged \u226515 years with pulmonary TB. At sites in Eldoret, Kenya, and Mbarara, Uganda, questionnaires ascertained timing of recalled TB symptom onset, number\/setting of healthcare visits prior to TB diagnosis, symptoms, demographics, food insecurity, and TB- and HIV-related stigma. Robust negative binomial regression was used to examine factors associated with longer overall duration from TB symptom onset to documented treatment initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 264 participants\u2014median age 33 years (IQR, 25\u201343 years), 67% male, 31% people with HIV, 51% urban residents\u2014median duration from TB symptom onset to treatment initiation was 65.5 days (IQR, 33\u2013131 days). Longer time to TB treatment was associated with female sex (adjusted incidence rate ratio [aIRR], 1.27 [95% CI, 1.00\u20131.61]); previous care-seeking at a pharmacy (aIRR, 1.53 [95% CI, 1.22\u20131.92]), and presence of dyspnea (aIRR, 1.43 [95% CI, 1.09\u20131.86]) or fatigue (aIRR, 1.63 [95% CI, 1.11\u20132.37]) at initiation. Shorter duration to TB treatment was associated with HIV-positive status (aIRR, 0.50 [95% CI, .39\u2013.64]). Among people with HIV, shorter duration to TB treatment was associated with CD4 count &amp;lt;200\u2005cells\/\u03bcL (aIRR, 0.63 [95% CI, .43\u2013.93]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Interventions are needed to increase community-level TB diagnostic access, including at pharmacies and lower levels of care. Decentralized TB testing strategies and tailored interventions for groups with lower care access should be pursued.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag392","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T10:48:45Z","timestamp":1783680525000},"source":"Crossref","is-referenced-by-count":0,"title":["Delays in Tuberculosis Treatment Among People With Pulmonary Tuberculosis in East Africa: Findings From a Prospective Cohort Study"],"prefix":"10.1093","volume":"13","author":[{"given":"Kirsten","family":"Prabhudas-Strycker","sequence":"first","affiliation":[{"name":"The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine , Indianapolis, Indiana ,","place":["USA"]},{"name":"Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana 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