Биология ва тиббиёт муаммолари 2026, №1 (167)
Subject of the article
PATIENT REFERRAL PATHWAYS AND DIAGNOSTIC TIMING OF ACUTE LEUKEMIA IN CHILDREN IN TAJIKISTAN (317-320)
Authors
Khodjaeva Nikzan Nazarbekovna, Sodikov Naimjon Makhmadaminovich, Makhfuzulloh Azimi, Khojaeva Farangis Murodovna, Berger Inna Viktorovna, Rasulova Nodira Alihserovna
Institution
1 - Avicenna Tajik State Medical University, Dushanbe Tajikistan; 2 – Farabi Medical Center, Dushanbe, Tajikistan; 3 - Republican Scientific and Practical Medical Center of Hematology, Ministry of Health of the Republic of Uzbekistan, Tashkent; 4 - Samarkand State Medical University, Republic of Uzbekistan, Samarkand
Abstract
Acute leukemia is the most common malignant disease in childhood and remains a major cause of morbidity and mortality. Although advances in treatment have significantly improved survival in high-income countries, outcomes in low- and middle-income settings continue to lag behind. One of the most important prognostic determinants is the timeliness of diagnosis, which in many regions is influenced by healthcare system organization and access to specialized care. The median overall diagnostic interval was 45.2 ± 12.8 days. The longest delays occurred at the pre-specialist stage, particularly between initial medical contact and referral to a pediatric hematologist. Signifi-cant predictors of diagnostic delay included first presentation at primary healthcare facilities (OR 2.8; 95% CI 1.9–4.1), absence of a complete blood count at initial evaluation (OR 3.2; 95% CI 2.1–4.9), rural residence (OR 2.1; 95% CI 1.4–3.2), and limited availability of automated hematology analyzers in peripheral medical institutions (OR 3.8; 95% CI 2.5–5.4). Children with acute leukemia in Tajikistan experience substantial delays in diagnosis, primarily due to organizational and infrastructural limitations within the healthcare system. Improving early recognition at the primary care level, standardizing diagnostic algorithms, and expanding access to basic labora-tory diagnostics may significantly reduce diagnostic delays and improve clinical outcomes.
Key words
Acute leukemia; pediatric oncology; diagnostic delay; referral pathways; primary healthcare; Tajikistan.
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