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Determinants of patient delay in diagnosis of pulmonary tuberculosis in somali pastoralist setting of Ethiopia : a matched case-control study

Getnet, Fentabil and Demissie, Meaza and Worku, Alemayehu and Gobena, Tesfaye and Seyoum, Berhanu and Tschopp, Rea and Andersen, Christopher T.. (2019) Determinants of patient delay in diagnosis of pulmonary tuberculosis in somali pastoralist setting of Ethiopia : a matched case-control study. International journal of environmental research and public health, 16 (18). p. 3391.

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Abstract

Background; : Healthcare-seeking behavior is the basis to ensure early diagnosis and treatment of tuberculosis (TB) in settings where most cases are diagnosed upon self-presentation to health facilities. Yet, many patients seek delayed healthcare. Thus, we aimed to identify the determinants of patient delay in diagnosis of pulmonary TB in Somali pastoralist area, Ethiopia.; Methods; : A matched case-control study was conducted between December 2017 and October 2018. Cases were self-presented and newly diagnosed pulmonary TB patients aged ≥ 15 years who delayed > 30 days without healthcare provider consultation, and controls were patients with similar inclusion criteria but who consulted a healthcare provider within 30 days of illness; 216 cases sex-matched with 226 controls were interviewed using a pre-tested questionnaire. Hierarchical analysis was done using conditional logistic regression.; Results; : After multilevel analysis, pastoralism, rural residence, poor knowledge of TB symptoms and expectation of self-healing were individual-related determinants. Mild-disease and manifesting a single symptom were disease-related, and >1 h walking distance to nearest facility and care-seeking from traditional/religious healers were health system-related determinants of patient delay > 30 days [; p; < 0.05].; Conclusion; : Expansion of TB services, mobile screening services, and arming community figures to identify and link presumptive cases can be effective strategies to improve case detection in pastoral settings.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Human and Animal Health > One Health (Zinsstag)
UniBasel Contributors:Tschopp, Rea
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Multidisciplinary Digital Publishing Institute
ISSN:1661-7827
e-ISSN:1660-4601
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:30 Sep 2019 07:46
Deposited On:30 Sep 2019 07:46

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