Health care seeking among pulmonary tuberculosis suspects and patients in rural Ethiopia: a community-based study

Abstract

BackgroundHealth care seeking is a dynamic process that is influenced by socio-demographic, cultural and other factors. In Ethiopia, there are limited studies regarding the health seeking behaviour of tuberculosis (TB) suspects and TB patients. However, a thorough understanding of patients' motivation and actions is crucial to understanding TB and the treatment of disease. Such insights would conceivably help to reduce delay in diagnosis, improve treatment adherence and thereby reduce transmission of TB in the community. The objective of this study was to describe and analyze health care seeking among TB suspects and pulmonary TB (PTB) cases in a rural district of the Amhara Region in Ethiopia.MethodsStudy kebeles were randomly selected in a cross-sectional study design. House-to-house visits were conducted in which individuals aged 15 years and above in all households of the kebeles were included. Subjects with symptoms suggestive of TB were interviewed about their health seeking behaviour, socio-demographic and clinical factors using a semi-structured questionnaire. Logistics regression analysis was employed to assess associations between the independent and outcome variables.ResultsThe majority, 787 (78%), TB suspects and 33 (82.5%) PTB cases had taken health care actions for symptoms from sources outside their homes. The median delay before the first action was 30 days. In logistics regression, women (AOR 0.8, 95% CI 0.6, 0.9) were found to be less likely to visit a medical health provider than men. Those with a long duration of cough (AOR 1.5, 95% CI 1.03, 2.1) and those with a previous history of TB (AOR 1.5, 95% CI 1.03, 2.3) were more likely to visit a medical health provider compared to those with a shorter duration of cough and with no history of TB.ConclusionThe majority of TB suspects and PTB cases had already taken health care actions for their symptoms at the time of the survey. The availability of a simple and rapid diagnostic TB test for use at the lowest level of health care and the involvement of all health providers in case finding activities are imperative for early TB case detection.

Smear positive pulmonary tuberculosis among suspected patients attending metehara sugar factory hospital; eastern Ethiopia

“…The finding of this study is higher than a study done in Jimma Seka, Ethiopia (2010), West Gojam Ethiopia (2009) and cape town, South Africa (2006) which reported the prevalence of sputum smear positive as 10.6% ,4% and 8.5% respectively 10,12,13 . The possible justification for this discrepancy might be associated with the methodology difference; the above mentioned studies screened acid fast bacilli by Ziehl-Neelsen staining technique in direct smear which has low sensitivity as compared to bleach concentrated smears.…”

Mycobacterium tuberculosis Lineage 7 Strains Are Associated with Prolonged Patient Delay in Seeking Treatment for Pulmonary Tuberculosis in Amhara Region, Ethiopia

“…Thus, more intense efforts to identify active cases are recommended in order to control the spread of TB disease. The duration of TB symptoms, time of health care seeking, and associated factors have been studied in many countries (23)(24)(25)(26)(27)(28)(29). Various sociodemographic and clinical factors have been identified as predictors of delay in seeking care.…”

Assessment of Patients' Knowledge, Attitude, and Practice Regarding Pulmonary Tuberculosis in Eastern Amhara Regional State, Ethiopia: Cross-Sectional Study

“…This might be a result of culture, low financial capacity, health perception, stigma, and socio-psychological barriers (beliefs). 11,12,14,15,22 As a result, correct knowledge and positive perception of the patient toward TB and its management is a prerequisite for them to seek early health care.…”