Pulmonary tuberculosis in Patna, India: Durations, delays, and health care seeking behaviour among patients identified through household surveys

DOI

10.1016/j.jegh.2017.08.001How to use a DOI?

Keywords

Delays; Pathways to care; Patna; Private providers; Pulmonary tuberculosis

Abstract

Background: Delays in accessing effective health care plays a pivotal role in increasing Tuberculosis (TB) transmission within the community. Patna, North India, with high levels of poverty and weak public health system, faces huge challenges for achieving effective TB control. The study aims to determine delays that occur from onset of TB symptoms until initiation of pulmonary TB (PTB) treatment among patients in Patna.

Methods: Of the 109 self-reporting TB patients identified through an active household survey, 64 PTB patients were interviewed. First care seeking, TB diagnostic and treatment initiation durations were calculated and delays defined for new and retreatment patients and minors and adults. Outliers exhibiting extreme delays were additionally identified.

Results: A cross sMean total pathway duration for TB care was 40 days, with diagnostic duration contributing to 58% of the duration. No significant differences were noted between new and retreatment patients. Minors, comprising of 30% of total PTB patients accessed care faster than adults, but showed significantly higher diagnostic duration (38 days vs. 17 days). Preference for private sector, chemists and allopaths was seen throughout the pathway.

Discussion: Patna requires a more effective harnessing of the private sector augmented with reliable diagnostic investigations and a focus on quality.

Copyright

© 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd.

Open Access

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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TY  - JOUR
AU  - Nerges Mistry
AU  - Eunice Lobo
AU  - Shimoni Shah
AU  - Sheela Rangan
AU  - Yatin Dholakia
PY  - 2017
DA  - 2017/08/10
TI  - Pulmonary tuberculosis in Patna, India: Durations, delays, and health care seeking behaviour among patients identified through household surveys
JO  - Journal of Epidemiology and Global Health
SP  - 241
EP  - 248
VL  - 7
IS  - 4
SN  - 2210-6014
UR  - https://doi.org/10.1016/j.jegh.2017.08.001
DO  - 10.1016/j.jegh.2017.08.001
ID  - Mistry2017
ER  -