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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Factors associated with patient and health care system delay in diagnosis for tuberculosis in the province of Luanda, Angola
BMC Infectious Diseases, Volume 13, No. 1, Article 168, Year 2013
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Description
Background: Tuberculosis (TB) is still a great challenge to public health in sub-Saharan Africa. Most transmissions occur between the onset of coughing and initiation of treatment. Delay in diagnosis is significant to disease prognosis, thus early diagnosis and prompt effective therapy represent the key elements in controlling the disease. The objective of this study was to investigate the factors influencing the patient delay and the health system delay in TB diagnosis in Angola.Methods: On a cross-sectional study, 385 TB patients who visited 21 DOTS clinics in Luanda were included consecutively. The time from the onset of symptoms to the first consultation of health providers (patients' delay) and the time from the first consultation to the date of diagnosis (health system's delay) were analysed. Bivariate and logistics regression were applied to analyse the risk factors of delays.Results: The median total time elapsed from the onset of symptoms to diagnosis was 45 days (interquartile range [IQR]: 21-97 days). The median patient delay was 30 days (IQR: 14-60 days), and the median health care system delay was 7 days (IQR: 5-15 days). Primary education (AOR = 1.75; CI [95%] 1.06-2.88; p <0.029) and the health centre of the first contact differing from the DOTS centre (AOR = 1.66; CI [95%] 1.01-2.75; p <0.046) were independent risk factors for patient delay >4 weeks. Living in a suburban area (AOR = 2,32; CI [95%] 1.21-4.46; p = 0.011), having a waiting time in the centre >1 hour (AOR = 4.37; CI [95%] 1.72-11.14; p = 0.002) and the health centre of the first contact differening from the DOTS centre (AOR = 5.68; CI [95%] 2.72-11,83; p < 0,00001) were factors influencing the system delay.Conclusions: The results indicate that the delay is principally due to the time elapsed between the onset of symptoms and the first consultation. More efforts should be placed in ensuring the availability of essential resources and skills in all healthcare facilities other than the DOTS centres, especially those located in suburban areas. © 2013 Segagni Lusignani et al.; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3637285/bin/1471-2334-13-168-S1.pdf
Authors & Co-Authors
Segagni Lusignani, Luigi
Austria, Vienna
Allgemeines Krankenhaus Wien
Italy, Padua
Doctors with Africa Cuamm
Quaglio, Gianluca
Italy, Padua
Doctors with Africa Cuamm
Italy, Treviso
Azienda Ulss 9
Atzori, Andrea
Italy, Padua
Doctors with Africa Cuamm
Nsuka, Joseph
Angola, Luanda
Luanda Tuberculosis and Leprosy Dispensary
Grainger, Ross
Italy, Padua
Doctors with Africa Cuamm
Da Conceiçao Palma, Maria
Angola, Luanda
National Plan Against tb
Putoto, Giovanni
Italy, Padua
Doctors with Africa Cuamm
Manenti, Fabio
Italy, Padua
Doctors with Africa Cuamm
Statistics
Citations: 66
Authors: 8
Affiliations: 5
Identifiers
Doi:
10.1186/1471-2334-13-168
e-ISSN:
14712334
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Angola