Diagnostic and treatment delay among Tuberculosis patients in Afar Region, Ethiopia: A cross-sectional study

被引：73

作者：

Belay, Mulugeta ^{[1
,2
]}

Bjune, Gunnar ^{[2
]}

Ameni, Gobena ^{[1
]}

Abebe, Fekadu ^{[2
]}

机构：

[1] Univ Addis Ababa, Aklilu Lemma Inst Pathobiol, Addis Ababa, Ethiopia

[2] Univ Oslo, Inst Hlth & Soc, Dept Community Med, Sect Int Hlth, N-0318 Oslo, Norway

来源：

BMC PUBLIC HEALTH | 2012年 / 12卷

关键词：

Tuberculosis; Patients' delay; Health system's delay; Afar Region; Ethiopia; HEALTH SYSTEM DELAYS; PULMONARY TUBERCULOSIS; PERCEPTION;

D O I：

10.1186/1471-2458-12-369

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background: TB is a major public health problem globally and Ethiopia is 8th among the 22 high burden countries. Early detection and effective treatment are pre-requisites for a successful TB control programme. In this regard, early health seeking action from patients' side and prompt diagnosis as well as initiation of treatment from the health system's side are essential steps. The aim of this study was to assess delay in the diagnosis and treatment of TB in a predominantly pastoralist area in Ethiopia. Methods: On a cross-sectional study, two hundred sixteen TB patients who visited DOTS clinics of two health facilities in Afar Region were included consecutively. Time from onset of symptoms till first consultation of formal health providers (patients' delay) and time from first consultation till initiation of treatment (health system's delay) were analyzed. Results: The median patients' and health system's delay were 20 and 33.5 days, respectively. The median total delay was 70.5 days with a median treatment delay of 1 day. On multivariate logistic regression, self-treatment (aOR. 3.99, CI 1.50-10.59) and first visit to non-formal health providers (aOR. 6.18, CI 1.84-20.76) were observed to be independent predictors of patients' delay. On the other hand, having extra-pulmonary TB (aOR. 2.08, CI 1.08-4.04), and a first visit to health posts/clinics (aOR. 19.70, CI 6.18-62.79), health centres (aOR. 4.83, CI 2.23-10.43) and private health facilities (aOR. 2.49, CI 1.07-5.84) were found to be independent predictors of health system's delay. Conclusions: There is a long delay in the diagnosis and initiation of treatment and this was mainly attributable to the health system. Health system strengthening towards improved diagnosis of TB could reduce the long health system's delay in the management of TB in the study area.

引用

页数：8

共 28 条

[11]

Lawn SD, 1998, INT J TUBERC LUNG D, V2, P635

[12] Knowledge and perception of pulmonary tuberculosis in pastoral communities in the middle and Lower Awash Valley of Afar region, Ethiopia [J].

Legesse, Mengistu ;

Ameni, Gobena ;

Mamo, Gezahegne ;

Medhin, Girmay ;

Shawel, Dawit ;

Bjune, Gunnar ;

Abebe, Fekadu .

BMC PUBLIC HEALTH, 2010, 10

[13]

Lewis K E, 2003, Commun Dis Public Health, V6, P133

[14] From their own perspective. A Kenyan community's perception of tuberculosis [J].

Liefooghe, R ;

Baliddawa, JB ;

Kipruto, EM ;

Vermeire, C ;

DeMunynck, AO .

TROPICAL MEDICINE & INTERNATIONAL HEALTH, 1997, 2 (08) :809-821

[15]

Menbere G, 2011, POTENTIAL DAGU COMMU

[16] Delayed consultation among pulmonary tuberculosis patients: a cross sectional study of 10 DOTS districts of Ethiopia [J].

Mesfin, Mengiste M. ;

Newell, James N. ;

Walley, John D. ;

Gessessew, Amanuel ;

Madeley, Richard J. .

BMC PUBLIC HEALTH, 2009, 9

[17] Patterns of delays amongst pulmonary tuberculosis patients in Lagos, Nigeria [J].

Odusanya, OO ;

Babafemi, JO .

BMC PUBLIC HEALTH, 2004, 4 (1) :1-5

[18] Time to initiation of anti-tuberculosis treatment [J].

Pirkis, JE ;

Speed, BR ;

Yung, AP ;

Dunt, DR ;

MacIntyre, CR .

TUBERCLE AND LUNG DISEASE, 1996, 77 (05) :401-406

[19]

Population Census Commission, 2008, SUMM STAT REP 2007 P

[20]

Rajeswari R, 2002, INT J TUBERC LUNG D, V6, P789

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