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BMC Public Health
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Patient and health system delay among patients with pulmonary tuberculosis in Beira city, Mozambique

Authors: Abuchahama Saifodine, Paula Samo Gudo, Mohsin Sidat, James Black

Published in: BMC Public Health | Issue 1/2013

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Abstract

Background

TB control is based on the rapid identification of cases and their effective treatment. However, many studies have shown that there are important delays in diagnosis and treatment of patients with TB. The purpose of this study was to assess the prevalence of and identify risk factors associated with patient delay and health system delay among newly diagnosed patients with pulmonary TB.

Methods

A cross sectional study was carried out in Beira city, Mozambique between September 2009 and February 2010. Patients in the first month of treatment were consecutively selected to this study if they had a diagnosis of pulmonary TB, had no history of previous TB treatment, and were 18 years or older and provided informed consent. Data was obtained through a questionnaire administered to the patients and from patients’ files.

Results

Among the 622 patients included in the study the median age was 32 years (interquartile range, 26–40) and 272 (43.7%) were females. The median total delay, patient delay and health system delay was 150 days (interquartile range, 91–240), 61 days (28–113) and 62 days (37–120), respectively. The contribution of patient delay and health system delay to total delay was similar. Farming, visiting first a traditional healer, low TB knowledge and coexistence of a chronic disease were associated with increased patient delay. More than two visits to a health facility, farming and coexistence of a chronic disease were associated with increased health system delay.

Conclusions

This study revealed a long total delay with a similar contribution of patient delay and health system delay. To reduce the total delay in this setting we need a combination of interventions to encourage patients to seek appropriate health care earlier and to expedite TB diagnosis within the health care system.

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Metadata
Title
Patient and health system delay among patients with pulmonary tuberculosis in Beira city, Mozambique
Authors
Abuchahama Saifodine
Paula Samo Gudo
Mohsin Sidat
James Black
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-559

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