Health care-seeking behaviour among people with cough in Tanzania: findings from a tuberculosis prevalence survey

Senkoro, Mbazi; Hinderaker, Sven Gudmund; Mfinanga, S.; Range, Nyagosya; Kamara, D V; Egwaga, Saidi; Leth, Frank van

doi:10.5588/ijtld.14.0499

Cited by 31 publications

(39 citation statements)

References 24 publications

(29 reference statements)

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“…Our findings affirm the findings of the First National Tuberculosis Prevalence Survey in Tanzania where prevalence was higher in males than in females 13 . The findings are consistent with results from China 14 and India 15 as well as studies in Ethiopia and Brazil where males were reported to have an increased risk of TB even in HIV-infected population 16,17 .…”

Section: Discussionsupporting

confidence: 82%

Tuberculosis among HIV-infected population: incidence and risk factors in rural Tanzania

Said¹,

Verver²,

Kalingonji

et al. 2017

Afr H. Sci.

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Background: The incidence of tuberculosis among HIV-infected populations with high CD4 count in high burden countries has not been well studied. Objective: To assess the TB incidence in HIV-infected adults and its associated risk factors. Method: A cohort study with retrospective review of medical records and prospective follow-up of HIV-infected adult participants attending CTC who were 18-55 years old, had CD4 count more than 250 cells/mm 3 in the period of 2008-2010 and were not on ART at enrolment. Cox proportional hazard regression was used to explore the predictors of incident TB. Results: Overall 777 (24%) of 3,279 CTC enrolled HIV-infected adults fulfilled the inclusion criteria of the study. The incidence of TB in the study population ranged from 0.8/100 per person years (PY) at risk (95% CI 0.5-1.3) in the main analysis to 1.7/100 PY at risk (95% CI 1.0-2.6) in sensitivity analyses. Only prior history of TB disease was found to have a significant association with an increased risk of TB, hazard ratio 5.7 (95% CI 2.0-16.4, p value 0.001). Conclusion: Tuberculosis incidence among HIV-infected adults with medium/high CD4 count in Bagamoyo is lower than in other high TB burden countries. Previously TB treated patients have a much higher risk of getting TB again than those who never had TB before.

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Section: Discussionsupporting

confidence: 82%

Tuberculosis among HIV-infected population: incidence and risk factors in rural Tanzania

Said¹,

Verver²,

Kalingonji

et al. 2017

Afr H. Sci.

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“…In almost half of these cases, the disease remains undiagnosed until death [2]. TB patients are often diagnosed at the later stages of the disease, due to health-seeking behaviour, inappropriate diagnostic investigations requested by health care providers, and limited diagnostic capacities at health care facilities (HCFs) [3, 4]. Patients experiencing TB symptoms may initially seek relief by using self-prescribed medication or by consulting a health care provider who does not request TB investigations despite repeated visits [5].…”

Section: Introductionmentioning

confidence: 99%

“…Delay in seeking care, therefore, promotes continued TB transmission [9]. The complex pathway to care, from the onset of symptoms to diagnosis and treatment, may result in delays in seeking care and contribute to patient morbidity and mortality [4, 10]. …”

Section: Introductionmentioning

confidence: 99%

“…TB case detection in Tanzania largely relies on passive case detection when patients present themselves to HCFs, which likely leads to longer diagnostic delays [12]. The first national TB prevalence survey in Tanzania in 2012 showed that only 30% of people with TB symptoms sought health care and almost half of these did not undergo diagnostic procedures for TB [4]. To better understand this situation, we studied the extent of diagnostic delay of TB, its associated risk factors and factors contributing to health-seeking behaviour among newly diagnosed smear-positive adult pulmonary TB (PTB) patients in Dar es Salaam, an urban region in Tanzania with a high TB burden.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic delay and associated factors among patients with pulmonary tuberculosis in Dar es Salaam, Tanzania

et al. 2017

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BackgroundTanzania is among the 30 countries with the highest tuberculosis (TB) burdens. Because TB has a long infectious period, early diagnosis is not only important for reducing transmission, but also for improving treatment outcomes. We assessed diagnostic delay and associated factors among infectious TB patients.MethodsWe interviewed new smear-positive adult pulmonary TB patients enrolled in an ongoing TB cohort study in Dar es Salaam, Tanzania, between November 2013 and June 2015. TB patients were interviewed to collect information on socio-demographics, socio-economic status, health-seeking behaviour, and residential geocodes. We categorized diagnostic delay into ≤ 3 or > 3 weeks. We used logistic regression models to identify risk factors for diagnostic delay, presented as crude (OR) and adjusted Odds Ratios (aOR). We also assessed association between geographical distance (incremental increase of 500 meters between household and the nearest pharmacy) with binary outcomes.ResultsWe analysed 513 patients with a median age of 34 years (interquartile range 27–41); 353 (69%) were men. Overall, 444 (87%) reported seeking care from health care providers prior to TB diagnosis, of whom 211 (48%) sought care > 2 times. Only six (1%) visited traditional healers before TB diagnosis. Diagnostic delay was positively associated with absence of chest pain (aOR = 7.97, 95% confidence intervals [CI]: 3.15–20.19; P < 0.001), and presence of hemoptysis (aOR = 25.37, 95% CI: 11.15–57.74; P < 0.001) and negatively associated with use of medication prior to TB diagnosis (aOR = 0.31, 95% CI: 0.14–0.71; P = 0.01). Age, sex, HIV status, education level, household income, and visiting health care facilities (HCFs) were not associated with diagnostic delay. Patients living far from pharmacies were less likely to visit a HCF (incremental increase of distance versus visit to any facility: OR = 0.51, 95% CI: 0.28–0.96; P = 0.037).ConclusionsTB diagnostic delay was common in Dar es Salaam, and was more likely among patients without prior use of medication and presenting with hemoptysis. Geographical distance to HCFs may have an impact on health-seeking behaviour. Increasing community awareness of TB signs and symptoms could further reduce diagnostic delays and interrupt TB transmission.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-017-0276-4) contains supplementary material, which is available to authorized users.

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“…It particularly infects lungs, although other organ infections are also observed. Main symptoms of Tuberculosis are continuous fever and cough for more than two weeks [2]. More than 8.5 million new cases of TB were recorded in 2010 of which more than 95% were identified in developing countries and 65% in Asia [3].…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis Control Program in Sistan: An Eligible Model of A Tropical Area: Environmental and Epidemiological Reasons for Tuberculosis Resistance

Sepehri¹

2017

Foc Sci

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Introduction: Tuberculosis (TB) is known as an infectious disease with high burden from a long time. Various strategies are implemented to control its spread in the world and this study is to evaluate Tuberculosis Control Program in Sistan. Methods: For this purpose we collected data with the methods of questionnaires, checklists, interviews, documentation review and observation. Using these methods together with data collection will boost the advantages of each single method. Data analyzed by using SPSS-18 software. We considered differences as significant at the level of P < 0.05. Results: Effectiveness and Cost-Benefit considered as the priorities of TCPS evaluation. Current study showed TCPS reduced delayed time between case detection and treatment initiation to less than one week. TB incidence was 96 and 107 per 100,000 of population respectively in 2011 and 2012 i.e. one year before and after TCPS implementation. It increased case detection but SPSS Kruskal Wallis test showed there was not a significant change according to TCPS implementation (P > 0.05). It didn't have a significant change in patient destiny after implementation. From the each dollar we spend in TCPS implementation (COST), about 0.86 dollar was saved. Conclusions: The reason why TCPS is not fully successful is because either the TB infected contacts were not screened or due to TCPS deviation from world health organization procedures. Current study showed from the each dollar we spend in TCPS implementation, about 0.86 dollar was saved.

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Health care-seeking behaviour among people with cough in Tanzania: findings from a tuberculosis prevalence survey

Abstract: A third of the persons with cough symptoms consistent with TB had sought health care. About 42% sought care in sites with TB diagnostic capacity, but most did not undergo TB diagnostic procedures, precluding a timely diagnosis.

Cited by 31 publications

References 24 publications

Tuberculosis among HIV-infected population: incidence and risk factors in rural Tanzania

Tuberculosis among HIV-infected population: incidence and risk factors in rural Tanzania

Diagnostic delay and associated factors among patients with pulmonary tuberculosis in Dar es Salaam, Tanzania

Tuberculosis Control Program in Sistan: An Eligible Model of A Tropical Area: Environmental and Epidemiological Reasons for Tuberculosis Resistance

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