Delay in DOTS for new pulmonary tuberculosis patient from rural area of Wardha District, India

Bawankule, S.; Gaidhane, A.; Quazi, S.Z.. and Khatib, N. (2010) Delay in DOTS for new pulmonary tuberculosis patient from rural area of Wardha District, India. Online Journal of Health and Allied Sciences, 9 (1). ISSN 0972-5997

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Abstract

Vast majority of active tuberculosis patients seeks treatment, do so promptly, still many patients spend a great deal of time and money “shopping for health” and too often they do not receive either accurate diagnosis or effective treatment, despite spending considerable resources. Objective: To find out the time taken to, for diagnosis of tuberculosis and to put patient on DOTS from the onset of symptoms and pattern of health seeking behavior of new pulmonary tuberculosis patients. A cross-sectional rapid assessment using qualitative (FGD) and quantitative (Interview) methods conducted at DOTS center of tertiary care hospital from rural Wardha. Participants: 53 pulmonary tuberculosis patients already on DOTS, in intensive phase. Main outcome measure: Delay in initiation of DOTS & health seeking behavior Results: Median total delay for starting DOTS was 111 days, (range: 10 to 321 days). Patient delay was more than provider delay. Patients delay was more in patients above 60 years, illiterate, per-capita income below 650 Rupees and HIV TB co-infection. Pattern of health seeking behavior was complex. Family physician was the preferred health care provider. Patient visited on an average four providers and spent around 1450 rupees (only direct cost) before DOTS begin. Time taken from the onset of symptoms and start of DOT is a cause of concern for the tuberculosis control program. Early case detection is important rather than mere achieving target of 70% new case detection. Program manager needs to implement locally relevant & focused strategies for early case detection to improve the treatment success, especially in rural area of India.

EPrint Type:Article
Uncontrolled Keywords:Tuberculosis, RNTCP, DOTS, Treatment Delays, Health Seeking Behavior, Rural Areas, Pulmonary Tuberculosis, Tuberculosis Control Programme
Subjects:Bacterial Infections and Mycoses > Bacterial Infections > Gram-Positive Bacterial Infections > Actinomycetales Infections > Mycobacterium Infections > Tuberculosis
-Journal Repositories > Online Journal of Health and Allied Sciences
Therapeutics > Directly Observed Therapy
Persons > Patients
Behavior and Behavior Mechanisms > Attitude
Respiratory Tract Diseases > Lung Diseases > Tuberculosis, Pulmonary
Health Care Economics and Organizations > Health Planning > National Health Programs
Persons > Population Groups
Behavior and Behavior Mechanisms > Behavior
Respiratory Tract Diseases > Respiratory Tract Infections > Tuberculosis, Pulmonary
ID Code:3551
Deposited By:Dr Srinivas Kakkilaya
Deposited On:20 September 2010

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