{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T09:17:30Z","timestamp":1777972650369,"version":"3.51.4"},"reference-count":46,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Objectives: Diagnostic delay in pulmonary tuberculosis remains a significant barrier to effective disease control, even in low-incidence settings. This study aimed to identify factors associated with total delay and its components among adults with pulmonary tuberculosis in such a setting. Patients and methods: A retrospective observational study was conducted on adults with pulmonary tuberculosis treated at a tuberculosis care centre in Croatia. Total delay was defined as the interval between symptom onset and treatment initiation. Data were collected through structured patient interviews using a standardized questionnaire, medical record review, and routine tuberculosis notification forms from the national public health registry. Sociodemographic and clinical predictors were evaluated using multivariable linear and logistic regression analyses. Results: Among 116 participants, the median total delay was 85 days (interquartile range 48.5\u2013155.3). Rural residence was the strongest independent predictor, with patients experiencing an 88% longer delay than urban residents (p = 0.006). Individuals living in one-person households had a 49% longer delay (p = 0.047). Absence of chest pain was associated with shorter delay (\u221238%, p = 0.032) and lower odds of extreme delay (odds ratio 0.39, p = 0.047). Retired status independently predicted prolonged health system delay (42.1 days longer) and treatment delay (3.4 days longer). Conclusion: Prolonged delay may become increasingly important in the context of population ageing and changing household structures. Targeted strategies focused on rural, retired, and people living in one-person households may improve the timeliness of tuberculosis detection in settings where declining incidence can reduce clinical suspicion.<\/jats:p>","DOI":"10.3390\/tropicalmed11050120","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T07:57:29Z","timestamp":1777967849000},"page":"120","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rural Residence and One-Person Households Are Associated with Diagnostic Delay in Pulmonary Tuberculosis in a Low-Incidence European Setting"],"prefix":"10.3390","volume":"11","author":[{"given":"Tatjana","family":"Munko","sequence":"first","affiliation":[{"name":"Special Hospital for Pulmonary Diseases, Rockefeller\u2019s Street, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8145-6840","authenticated-orcid":false,"given":"Vesna","family":"Vuki\u010devi\u0107 Lazarevi\u0107","sequence":"additional","affiliation":[{"name":"Special Hospital for Pulmonary Diseases, Rockefeller\u2019s Street, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5743-5820","authenticated-orcid":false,"given":"Jelena","family":"Bari\u0161i\u0107","sequence":"additional","affiliation":[{"name":"Special Hospital for Pulmonary Diseases, Rockefeller\u2019s Street, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1934-7915","authenticated-orcid":false,"given":"Marina","family":"Perkovi\u0107","sequence":"additional","affiliation":[{"name":"Special Hospital for Pulmonary Diseases, Rockefeller\u2019s Street, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanja","family":"Vignjevi\u0107","sequence":"additional","affiliation":[{"name":"Roche Limited Liability Company, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"ref_1","unstructured":"(2026, February 04). 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