Knowledge about tuberculosis among doctors in primary health care institution in Montenegro

Rakočević, Božidarka; Medenica, Sanja; Bojovic, Olivera; Mugoša, Boban; Vukovic, Mirjana Nedovic; Grgurević, Anita

doi:10.1183/13993003.congress-2015.pa1522

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“…This is not satisfactory compared with 3-day delays in the health system of Nepal [ 18 ]. In regions such as Montenegro, where tuberculosis is not as common, it is indispensible to have experienced and qualified staff, as well as to improve the level of alertness for tuberculosis among primary health care physicians.Reports of the Institute of Public Health of Montenegro suggested that almost one half (48%) of chosen physicians in the primary health care institutions did not see any patient who had tuberculosis, while a total of 17.5% examined one patient with tuberculosis over the past two years [ 25 ]. Because of this, it is mandatory to include continuing education of primary health care physicians on tuberculosis, in order to reduce health system delays.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with patient and health system delays in diagnosis and treatment of tuberculosis in Montenegro, 2015–2016

et al. 2018

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BackgroundFundamental measures of control of tuberculosis are early detection and timely treatment of the affected. The aim of this study was to identify factors associated with patient-related and health system-related delays among patients with tuberculosis in the Republic of Montenegro.MethodsA cross-sectional study included 130 tuberculosis patients older than 15 years of age. The inclusion criteria were diagnosis of tuberculosis based on clinical, pathohistological and microbiological findings. Patient delay referred to the number of days between the onset of symptoms and the first consultation with general practitioner (GP). Health system delay represented the number of days between the first consultation with GP and the initiation of tuberculosis treatment.We classified delays longer than median delay length as 'prolonged delays'. Delays greater than 75th percentile of the maximum length of delay were classified as 'extreme delays'.ResultsDistribution of patient and health system delay in the overall delay was apprioximately equal (49% vs. 51%). Being married (OR = 2.54, p = 0.026) and having more negative attitudes towards tuberculosis (OR = 4.00, p = 0.045) were associated with extreme patient delay. Greater knowledge on tuberculosis was associated with lower likelihood of prolonged (OR = 0.24, p = 0.031) and extreme (OR = 0.30, p = 0.012) patient delay. Persons with negative sputum smear were more likely to experience prolonged (OR = 7.01, p<0.001) and extreme (OR = 4.40, p = 0.032) health system delay. Persons older than 47 years of age were more likely to experience prolonged health system delay (OR = 2.61, p = 0.042). Specialist consultation delay was associated with prolonged (OR = 1.08, p = 0.001) and extreme (OR = 1.05, p<0.001) health system delay.ConclusionContribution to overall delay is equally distributed between the patients and the health care system. Improvement of knowledge in the general population and continuing medical education of the health care workers on tuberculosis could lead to reduction in patient and health system delays in treatment of tuberculosis.

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Section: Discussionmentioning

confidence: 99%