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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Diagnostic and treatment delay among pulmonary tuberculosis patients in Ethiopia: A cross sectional study
BMC Infectious Diseases, Volume 5, Article 112, Year 2005
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Description
Background: Delayed diagnosis and treatment of tuberculosis (TB) results in severe disease and a higher mortality. It also leads to an increased period of infectivity in the community. The objective of this study was to determine the length of delays, and analyze the factors affecting the delay from onset of symptoms of pulmonary tuberculosis (PTB) until the commencement of treatment. Methods: In randomly selected TB management units (TBMUs), i.e. government health institutions which have diagnosing and treatment facilities for TB in Amhara Region, we conducted a cross sectional study from September 1-December 31/2003. Delay was analyzed from two perspectives, 1. Period between onset of TB symptoms to first visit to any health provider (health seeking period), and from the first health provider visit to initiation of treatment (health providers' delay), and 2. Period between onset of TB symptoms to first visit to a medical provider (patients' delay), and from this visit to commencement of anti-TB treatment (health systems' delay). Patients were interviewed on the same date of diagnosis using a semi-structured questionnaire. Logistics regression analysis was applied to analyze the risk factors of delays. Results: A total of 384 new smear positive PTB patients partici pated in the study. The median total delay was 80 days. The median health-seeking period and health providers' delays were 15 and 61 days, respectively. Conversely, the median patients' and health systems' delays were 30 and 21 days, respectively. Taking medical providers as a reference point, we found that forty eight percent of the subjects delayed for more than one month. Patients' delays were strongly associated with first visit to non-formal health providers and self treatment (P<0.0001). Prior attendance to a health post/clinic was associated with increased health systems' delay (p<0.0001). Conclusion: Delay in the diagnosis and treat ment of PTB is unacceptably high in Amhara region. Health providers' and health systems' delays represent the major portion of the total delay. Accessing a simple and rapid diagnostic test for TB at the lowest level of health care facility and encouraging a dialogue among all health providers are imperative interventions. © 2005 Yimer et al., licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC1326202/bin/1471-2334-5-112-S1.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC1326202/bin/1471-2334-5-112-S2.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC1326202/bin/1471-2334-5-112-S3.pdf
Authors & Co-Authors
Yimer, Solomon Abebe
Ethiopia
Amhara National Regional State Health Bureau
Norway, Oslo
Universitetet I Oslo
Bjune, Gunnar Aksel
Norway, Oslo
Universitetet I Oslo
Alene, Getu Degu
Ethiopia, Gondar
University of Gondar
Statistics
Citations: 263
Authors: 3
Affiliations: 3
Identifiers
Doi:
10.1186/1471-2334-5-112
ISSN:
14712334
e-ISSN:
14712334
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Ethiopia