Predictors of delayed care seeking for tuberculosis in southern India: an observational study

BMC Infectious Diseases

Research Article

Jane Pleskunas¹  Helen E. Jenkins²  Sarah E. Van Ness²  C. Robert Horsburgh³  Jerrold J. Ellner⁴  Natasha S. Hochberg⁵  Sonali Sarkar⁶  Gautam Roy⁶  Subitha Lakshminarayanan⁶  Swaroop Sahu⁶  Ankit Chandra⁶ 

[1] Boston Medical Center, Boston, MA, USA;Department of Biostatistics, Boston University, Crosstown Building, 801 Massachusetts Avenue, 3rd Floor, 02118, Boston, MA, USA;Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA;Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA;Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA;Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA;Department of Preventive and Social Medicine, JIPMER, Puducherry, India;

关键词: Alcohol;    Knowledge;    Income;    Cough;   

DOI  :  10.1186/s12879-017-2629-9

 received in 2017-03-16, accepted in 2017-07-24,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundReducing delay to accessing care is necessary to reduce the Tuberculosis (TB) burden in high incidence countries such as India. This study aimed to identify factors associated with delays in seeking care for TB in Southern India.MethodsWe analyzed data from newly diagnosed, smear-positive, culture-confirmed, pulmonary TB patients in the Regional Prospective Observational Research for TB (RePORT) cohort in Puducherry and Tamil Nadu, India. Data were collected on demographic characteristics, symptom duration, and TB knowledge, among other factors. Delay was defined as cough ≥4 weeks before treatment initiation. Risky alcohol use was defined by the AUDIT-C score which incorporates information about regular alcohol use and binge drinking. TB knowledge was assessed by knowing transmission mode or potential curability.ResultsOf 501 TB patients, 369 (73.7%) subjects delayed seeking care. In multivariable analysis, risky alcohol use was significantly associated with delay (aOR 2.20, 95% CI: 1.31, 3.68). Delay was less likely in lower versus higher income groups (<3000 versus >10,000 rupees/month, aOR 0.31, 95% CI: 0.12, 0.78). TB knowledge was not significantly associated with delay.ConclusionsLocal TB programs should consider that risky alcohol users may delay seeking care for TB. Further studies will be needed to determine why patients with higher income delay in seeking care.

【 授权许可】

CC BY   
© The Author(s). 2017