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Health-seeking behaviour and treatment delay in patients with pulmonary tuberculosis in Switzerland: some slip through the net

Auer, C. and Kiefer, S. and Zuske, M. and Schindler, C. and Wyss, K. and Blum, J. and Bosch-Capblanch, X. and Widmer, U. and Sauhier, S. and Janssens, J. P. and Bossard, K. and Chatonnet, C. and Mazza-Stalder, J. and Zacek, B. and Zellweger, J. P. and Altpeter, E. and Mäusezahl, M.. (2018) Health-seeking behaviour and treatment delay in patients with pulmonary tuberculosis in Switzerland: some slip through the net. Swiss Medical Weekly, 148. w14659.

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Abstract

To assess the health-seeking behaviour, the patient delay (onset of symptoms to first consultation) and the health system delay (first consultation to start of tuberculosis treatment) among patients with pulmonary tuberculosis (TB) diagnosed in Switzerland, and to assess the predictors of the various types of delay.
A survey among pulmonary TB patients was carried out in six cantons, covering 42% of all pulmonary adult TB cases notified in Switzerland. Data were collected by collaborators of the cantonal lung associations in charge of the follow-up of TB patients to investigate treatment seeking behaviour and to establish various delays and its predictors. Predictors of percentiles of delay (median and 75th percentile) were assessed using quantile regression.
Among 252 eligible patients, 162 patients could be interviewed. Of these, 20.4% were born in Switzerland. Cough as a symptom was mentioned by 76% of the interviewed patients. Almost half of the 162 patients (46%) consulted first a general practitioner in an ambulatory care setting and 26% approached a hospital first. The median delay between symptom onset and first healthcare contact (patient delay) was 5.2 weeks, which is slightly longer than findings in other low prevalence countries. The interquartile range was 1.6 to 14.2 weeks. The median delay between first consultation in Switzerland and the start of TB treatment (health system delay) was 2 weeks. The interquartile range was 0.6 to 7.1 weeks.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Biostatistics > Biostatistics Frequentist Modelling
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Former Units within Swiss TPH > Medical Practice Föhre (Blum)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Swiss Centre for International Health (SCIH) > Health Systems Support (Prytherch)
UniBasel Contributors:Auer, Christian and Kiefer, Sabine and Zuske, Meike and Schindler, Christian and Wyss, Kaspar and Blum, Johannes A. and Bosch-Capblanch, Xavier
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:EMH Schweizerischer Arzteverlag
ISSN:1424-7860
e-ISSN:1424-3997
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:05 Oct 2018 12:20
Deposited On:05 Oct 2018 12:20

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