Consulting private health care providers aggravates treatment delay in urban South African tuberculosis patients

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dc.contributor.authorVan Wyk S.S.
dc.contributor.authorEnarson D.A.
dc.contributor.authorBeyers N.
dc.contributor.authorLombard C.
dc.contributor.authorHesseling A.C.
dc.date.accessioned2011-10-13T16:58:31Z
dc.date.available2011-10-13T16:58:31Z
dc.date.issued2011
dc.description.abstractSETTING: An urban primary health care facility in Khayelitsha, South Africa. OBJECTIVES: To determine the difference in total tuberculosis (TB) treatment delay in patients who initially seek care at National TB Control Programme (NTP) facilities after the onset of TB-related symptoms, compared to patients who initially seek care from non-NTP health care practitioners (HCPs); and to describe the relative contributions of diagnostic, treatment initiation, patient and health system (HS) delay. DESIGN: A cross-sectional study of adult TB patients treated by the NTP. RESULTS: A total of 210 patients (median age 31 years) were enrolled from May to December 2009: 46% were male, and 58% were human immunodeficiency virus (HIV) infected. The median duration of total delay was 31 days, diagnostic delay 26, treatment initiation delay 0, patient delay 8 and HS delay 17 days. Initial visit to a non-NTP HCP was independently associated with total (P = 0.007), HS (P = 0.014) and diagnostic delays (P = 0.012). HIV infection was an independent risk factor for total (P = 0.047) and HS delay (P = 0.021); 27% of patients reported first going to a non-NTP HCP. CONCLUSION: Initial care sought from non-NTP HCPs was the main determinant of total, HS and diagnostic delays. Engagement and education of private HCPs is recommended. © 2011 The Union.
dc.description.versionArticle
dc.identifier.citationInternational Journal of Tuberculosis and Lung Disease
dc.identifier.citation15
dc.identifier.citation8
dc.identifier.citationhttp://www.scopus.com/inward/record.url?eid=2-s2.0-79960421310&partnerID=40&md5=81dd05df63b9b3191a08177182a7c020
dc.identifier.issn10273719
dc.identifier.other10.5588/ijtld.10.0615
dc.identifier.urihttp://hdl.handle.net/10019.1/16754
dc.subjectDiagnostic delay
dc.subjectPrivate sector
dc.subjectPublic sector
dc.subjectTreatment delay
dc.subjectTuberculosis
dc.subjecttuberculostatic agent
dc.subjectadult
dc.subjectarticle
dc.subjectattitude to health
dc.subjectcontrolled study
dc.subjectdelayed diagnosis
dc.subjectfemale
dc.subjecthealth care access
dc.subjecthealth care personnel
dc.subjecthealth care system
dc.subjecthealth care utilization
dc.subjecthelp seeking behavior
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectlung tuberculosis
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectpatient education
dc.subjectpriority journal
dc.subjectprivate hospital
dc.subjectpublic health service
dc.subjectrisk factor
dc.subjectSouth Africa
dc.subjecttherapy delay
dc.subjecturban area
dc.titleConsulting private health care providers aggravates treatment delay in urban South African tuberculosis patients
dc.typeArticle
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