Factors associated with delay in seeking care by tuberculosis patients

Dantas, Dândara Nayara Azevêdo; Enders, Bertha Cruz; Oliveira, Déborah Raquel Carvalho de; Vieira, Caroline Evelin Nascimento Kluczynic; Queiroz, Ana Angélica Rêgo de; Arcêncio, Ricardo Alexandre

doi:10.1590/0034-7167-2016-0680

Cited by 6 publications

(3 citation statements)

References 9 publications

(16 reference statements)

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“… 35 The inappropriate health-seeking behavior like self-medication could also contribute to the delay in the diagnosis and treatment by tuberculosis patients. 36 Compared to participants with a score of 0 on TB knowledge, participants with a score of 2 or more were more likely to have appropriate health-seeking preference. However, the awareness rate of key information on TB was only about 50% in Zhejiang Province.…”

Section: Discussionmentioning

confidence: 95%

<p>Factors Associated with Health-Seeking Preference Among People Who Were Supposed to Cough for More Than 2 Weeks: A Cross-Sectional Study in Southeast China</p>

Wang

Peng

et al. 2020

PPA

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Background The health-seeking preference of people with a cough >2 weeks had not been extensively researched in southeast China. The study aimed to explore factors associated with health-seeking preference, which could provide more evidence to improve individuals’ appropriate health-seeking behavior. Materials and Methods From October 2018 to December 2018, this cross-sectional study was conducted in Zhejiang, China. A questionnaire was used to collect information on sociodemographic characteristics, knowledge of tuberculosis (TB), and health-seeking preference. The chi-square test and multivariable logistic regression were performed to evaluate factors associated with health-seeking preference. Results Of the 7174 participants, 3321 (46.3%) were men, 6148 (85.7%) were married, and 6013 (83.8%) knew about TB. Appropriate health-seeking preference was reported by 6229 (86.8%) participants. Respondents knowing about TB were more likely to seek appropriate care than those did not (89.6% vs 72.4%, p<0.001). Of the 6013 participants knowing about TB, respondents with higher scores on five key items of TB knowledge were more likely to get appropriate health-seeking preference. About 805 (96.6%) participants with 5 scores on TB knowledge had appropriate care preference. Only 97 (72.4%) participants with a score of 0 reported an appropriate preference. Multivariable logistic regression showed residence, marital status, education level, occupation, and awareness of TB knowledge were predictors of appropriate health-seeking preference. Compared to participants with a score of 0 on five TB key knowledge, participants with a score of 5 were 8.57 times more likely to have appropriate health-seeking preference (95% confidence interval [CI]: 4.97–14.78), followed by a score of 4 (odds ratio [OR]=5.99, 95% CI, 3.23–8.03); 3 (OR=3.74, 95% CI, 2.44–5.74); 2 (OR=1.99, 95% CI, 1.30–3.02) and 1 (OR=1.17, 95% CI, 0.76–1.80). Conclusion Participants with little knowledge of TB had a low level of appropriate health-seeking preference. Appropriate health-seeking preference of the participants improved with increased key knowledge level of TB.

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Section: Discussionmentioning

confidence: 95%

<p>Factors Associated with Health-Seeking Preference Among People Who Were Supposed to Cough for More Than 2 Weeks: A Cross-Sectional Study in Southeast China</p>

Wang

Peng

et al. 2020

PPA

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“…Moreover, it is associated with high morbidity and mortality in immunosuppressed patients. Thus, early diagnosis and treatment are essential for effective TB control, especially in patients who have a broad-spectrum disease with atypical, extrapulmonary, and paucibacillary cases [1,4,5].…”

Section: Introductionmentioning

confidence: 99%

The Xpert® MTB/RIF diagnostic test for pulmonary and extrapulmonary tuberculosis in immunocompetent and immunocompromised patients: Benefits and experiences over 2 years in different clinical contexts

Tomaz¹,

Raboni²,

Kussen³

et al. 2021

PLoS ONE

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Xpert® MTB/RIF has been widely used for tuberculosis (TB) diagnosis in Brazil, since 2014. This prospective observational study aimed to evaluate the performance of Xpert in different contexts during a two-year period: (i) laboratory and clinical/epidemiological diagnosis; (ii) HIV-positive and -negative populations; (iii) type of specimens: pulmonary and extrapulmonary. Overall, 924 specimens from 743 patients were evaluated. The performance of the assays was evaluated considering culture (Lowenstein Jensen or LJ medium) results and composite reference standard (CRS) classification as gold standard. According to CRS evaluation, 219 cases (29.5%) were classified as positive cases, 157 (21.1%) as ‘possible TB’, and 367 (49.3%) as ‘not TB’. Based on culture, Xpert and AFB smear achieved a sensitivity of 96% and 62%, respectively, while based on CRS, the sensitivities of Xpert, AFB smear, and culture were 40.7%, 20%, and 25%, respectively. The pooled sensitivity and specificity of Xpert were 96% and 94%, respectively. Metric evaluations were similar between pulmonary and extrapulmonary samples against culture, whereas compared to CRS, the sensitivities were 44.6% and 29.3% for the pulmonary and extrapulmonary cases, respectively. The Xpert detected 42/69 (60.9%) patients with confirmed TB and negative culture on LJ medium, and 52/69 (75.4%) patients with negative AFB smear results. There was no significant difference in the diagnostic accuracy based on the types of specimens and population (positive- and negative-HIV). Molecular testing detected 13 cases of TB in culture-negative patients with severe immunosuppression. Resistance to rifampicin was detected in seven samples. Herein, Xpert showed improved detection of pulmonary and extrapulmonary TB cases, both among HIV-positive and -negative patients, even in cases with advanced immunosuppression, thereby performing better than multiple other diagnostic parameters.

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“…How prevalent this behavior is among women with ovarian cancer and why women buy products remain undetermined. However, the potential success of this line of investigation is supported by evidence of self-medication linked to an individual’s pathway to diagnosis relating to patient self-appraisal and self-management of symptoms in the decision to seek help [ 8 ]; the frequency drop of general practitioner (GP) consultations and patient self-misdiagnosis [ 9 ]; misdiagnosis and masking of symptoms [ 10 ]; and delay in seeking health care for rheumatoid arthritis [ 11 ], tuberculosis [ 12 ], and gastrointestinal cancers [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Using Shopping Data to Improve the Diagnosis of Ovarian Cancer: Computational Analysis of a Web-Based Survey

Dolan¹,

Goulding²,

Tata³

et al. 2023

JMIR Cancer

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Background Shopping data can be analyzed using machine learning techniques to study population health. It is unknown if the use of such methods can successfully investigate prediagnosis purchases linked to self-medication of symptoms of ovarian cancer. Objective The aims of this study were to gain new domain knowledge from women’s experiences, understand how women’s shopping behavior relates to their pathway to the diagnosis of ovarian cancer, and inform research on computational analysis of shopping data for population health. Methods A web-based survey on individuals’ shopping patterns prior to an ovarian cancer diagnosis was analyzed to identify key knowledge about health care purchases. Logistic regression and random forest models were employed to statistically examine how products linked to potential symptoms related to presentation to health care and timing of diagnosis. Results Of the 101 women surveyed with ovarian cancer, 58.4% (59/101) bought nonprescription health care products for up to more than a year prior to diagnosis, including pain relief and abdominal products. General practitioner advice was the primary reason for the purchases (23/59, 39%), with 51% (30/59) occurring due to a participant’s doctor believing their health problems were due to a condition other than ovarian cancer. Associations were shown between purchases made because a participant’s doctor believing their health problems were due to a condition other than ovarian cancer and the following variables: health problems for longer than a year prior to diagnosis (odds ratio [OR] 7.33, 95% CI 1.58-33.97), buying health care products for more than 6 months to a year (OR 3.82, 95% CI 1.04-13.98) or for more than a year (OR 7.64, 95% CI 1.38-42.33), and the number of health care product types purchased (OR 1.54, 95% CI 1.13-2.11). Purchasing patterns are shown to be potentially predictive of a participant’s doctor thinking their health problems were due to some condition other than ovarian cancer, with nested cross-validation of random forest classification models achieving an overall in-sample accuracy score of 89.1% and an out-of-sample score of 70.1%. Conclusions Women in the survey were 7 times more likely to have had a duration of more than a year of health problems prior to a diagnosis of ovarian cancer if they were self-medicating based on advice from a doctor rather than having made the decision to self-medicate independently. Predictive modelling indicates that women in such situations, who are self-medicating because their doctor believes their health problems may be due to a condition other than ovarian cancer, exhibit distinct shopping behaviors that may be identifiable within purchasing data. Through exploratory research combining women sharing their behaviors prior to diagnosis and computational analysis of these data, this study demonstrates that women’s shopping data could potentially be useful for early ovarian cancer detection.

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Factors associated with delay in seeking care by tuberculosis patients

Abstract: Self-medication contributes to the delay in the search for primary health care by tuberculosis patients.

Cited by 6 publications

References 9 publications

<p>Factors Associated with Health-Seeking Preference Among People Who Were Supposed to Cough for More Than 2 Weeks: A Cross-Sectional Study in Southeast China</p>

<p>Factors Associated with Health-Seeking Preference Among People Who Were Supposed to Cough for More Than 2 Weeks: A Cross-Sectional Study in Southeast China</p>

The Xpert® MTB/RIF diagnostic test for pulmonary and extrapulmonary tuberculosis in immunocompetent and immunocompromised patients: Benefits and experiences over 2 years in different clinical contexts

Using Shopping Data to Improve the Diagnosis of Ovarian Cancer: Computational Analysis of a Web-Based Survey

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