Pulmonary tuberculosis and health‐seeking behaviour: how to get a delayed diagnosis in Cali, Colombia

Abstract

SummaryTuberculosis is a heavy burden in the developing countries. Early diagnosis and adherence to treatment are difficult to achieve by patients. Our qualitative research looked at the paths followed and the barriers experienced by patients at the health care services of Cali, Colombia, while seeking help for pulmonary tuberculosis symptoms. Results show that the cultural-based explanation patients give to the symptoms, the stigma attached to the disease, and the poor quality of health care services (communication skills, organizational structure, attitudes, and knowledge of the tuberculosis control strategy of health care workers) are strong barriers to early diagnosis.keywords pulmonary tuberculosis, health-seeking behaviour, diagnosis correspondence Ernesto Jaramillo, Education and International Development

“Finally when I started falling down”: Indigenous tuberculosis patient experiences of health and illness on the Canadian prairies

“…al., 2010;Long, 2015;Ward, Marciniuk, Pahwa, & Hoeppner, 2004). The finding that TB symptoms were initially associated with other explanations, including other illnesses such as colds and flu, has been reported elsewhere (Auer, Sarol, Tanner, & Weiss, 2000;Jaramillo, 1998;Liefooghe, Baliddawa, Kipruto, Vermeire, & De Muynck, 1997;Mann Woith & Larson, 2008;Nnoaham, Pool, Bothamley, & Grant, 2006). Participants' stories also captured experiences consistent with a systematic review that identified delay in the diagnosis and treatment of TB because of the coexistence of chronic cough, rural residence, low healthcare access (geographic or sociopsychological), poverty, substance use, symptom management, and stigma (Storla, Yimer, & Bjune, 2008).…”

Percepciones y prácticas relacionadas con la tuberculosis y la adherencia al tratamiento en Chiapas, México

“…Un factor determinante en enfermos que utilizan la medicina alópata es la calidad del servicio de salud, principalmente en cuanto establecer una adecuada relación médico-paciente, tomando en cuenta los factores socioculturales, que según informes anteriores en otros países podrían ser una barrera mayor para el control de la tuberculosis. 22,23 En el ámbito mundial se han evaluado numerosas estrategias para incrementar la adherencia al tratamiento de la tuberculosis, tales como el Tratamiento acortado estrictamente supervisado (TAES), incentivos financieros, motivación, educación y hospitalización, y son las más efectivas la supervisión diaria del tratamiento y la combinación de dos o más estrategias. [24][25][26][27] Muchas de éstas, a pesar de su éxito, tienen problema en su aplicación y su continuidad, tal como sucedió con el TAES en Chiapas, 28 donde las áreas seleccionadas para esta estrategia reportan menores tasas de curación que en la totalidad del estado.…”

The tale of seeking treatment: A qualitative study of pulmonary tuberculosis patients

“…Another problem related to case detection is patient delay, which implies an overly long-time interval between the occurrences of the first symptoms and the patient's first visit to healthcare facilities (Hooi, 1994). People with pulmonary TB should be diagnosed as soon as possible to minimize the risk of spreading (Jaramillo, 1998;Jurcev-Savicevic & Kardum, 2012).…”

“…The research on HSB covered the discussion of the patients' decision making process in choosing healthcare facilities (traditional/modern healthcare facilities), the steps of undertaking treatment process and all determinant factors that underlie this process, and patient's perception of healthcare services (Kroeger, 1983). This research proven theoretically and practically useful in controlling and restraining the spreading of infectious diseases as investigating HSB helps health scientists and practitioners identify factors that hinder pulmonary patients to seek professional help (Abubakar et al, 2013;Jaramillo, 1998).…”