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Patient predictors of health-seeking behaviour for persons coughing for more than two weeks in high-burden tuberculosis communities : the case of the Western Cape, South Africa

dc.contributor.authorChristian, Carmenen_ZA
dc.contributor.authorBurger, Cobusen_ZA
dc.contributor.authorClaassens, Marelien_ZA
dc.contributor.authorBond, Virginiaen_ZA
dc.contributor.authorBurger, Ronelleen_ZA
dc.date.accessioned2019-06-20T13:39:07Z
dc.date.available2019-06-20T13:39:07Z
dc.date.issued2019
dc.identifier.citationChristian, C., et al. 2019. Patient predictors of health-seeking behaviour for persons coughing for more than two weeks in high-burden tuberculosis communities : the case of the Western Cape, South Africa. BMC Health Services Research, 19:160, doi:10.1186/s12913-019-3992-6
dc.identifier.issn1472-6963 (online)
dc.identifier.otherdoi:10.1186/s12913-019-3992-6
dc.identifier.urihttp://hdl.handle.net/10019.1/106283
dc.descriptionCITATION: Christian, C., et al. 2019. Patient predictors of health-seeking behaviour for persons coughing for more than two weeks in high-burden tuberculosis communities : the case of the Western Cape, South Africa. BMC Health Services Research, 19:160, doi:10.1186/s12913-019-3992-6.
dc.descriptionThe original publication is available at https://bmchealthservres.biomedcentral.com
dc.descriptionPublication of this article was funded by the Stellenbosch University Open Access Fund.
dc.description.abstractBackground: This study aimed to analyse the patient predictors of health-seeking behaviour for persons coughing for more than 2 weeks to better understand this vulnerable and important population. Methods: The study analysed data from a cohort study (SOCS - Secondary Outcome Cohort Study) embedded in a community randomised trial ZAMSTAR (Zambia and South Africa TB and AIDS Reduction Study) in eight high-burden TB communities in the Western Cape, South Africa. These datasets are unique as they contain TB-related data as well as data on health, health-seeking behaviour, lifestyle choices, employment, socio-economic status, education and stigma. We use uni- and multivariate logistic regressions to estimate the odds ratios of consulting for a cough (of more than 2 weeks duration) for a range of relevant patient predictors. Results: Three hundred and forty persons consulted someone about their cough and this represents 37% of the 922 participants who reported coughing for more than 2 weeks. In the multivariate analysis, respondents of black ethnic origin (OR 1.99, 95% CI 1.28–3.12, P < 0.01), those with higher levels of education (OR 1.05 per year of education, 95% CI 1.00–1.10, P = 0.05), and older respondents (OR 1.02 per year, 95% CI 1.01–1.04, P < 0.01) had a higher likelihood of consulting for their chronic cough. Individuals who smoked (OR 0.63, 95% CI 0.45–0.88, P < 0.01) and those with higher levels of socio-economic status (OR 0.81, 95% CI 0.71–0.92, P < 0.01) were less likely to consult. We find no evidence of stigma playing a role in health-seeking decisions, but caution that this may be due to the difficulty of accurately and reliably capturing stigma due to, amongst other factors, social desirability bias. Conclusions: The low levels of consultation for a cough of more than 2 weeks suggest that there are opportunities to improve case-finding. These findings on health-seeking behaviour can assist policymakers in designing TB screening and active case-finding interventions that are targeted to the characteristics of those with a chronic cough who do not seek care.en_ZA
dc.description.urihttps://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-3992-6
dc.format.extent8 pages ; illustrations
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)
dc.subjectChronic coughen_ZA
dc.subjectChronic diseases -- Patients -- Western Cape, South Africa -- Psychological aspectsen_ZA
dc.subjectPatient participation -- Western Cape, South Africaen_ZA
dc.subjectTuberculosis -- Patients -- Western Cape, South Africaen_ZA
dc.titlePatient predictors of health-seeking behaviour for persons coughing for more than two weeks in high-burden tuberculosis communities : the case of the Western Cape, South Africaen_ZA
dc.typeArticleen_ZA
dc.description.versionPublisher's version
dc.rights.holderAuthors retain copyright


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