SETTING: Ho Chi Minh City (HCMC), Vietnam. OBJECTIVES: To describe delay to diagnosis; to compare diagnostic procedures and referral routines used by private and public health care providers; and to examine associations between contact with various types of providers and risk of delay to TB diagnosis. DESIGN: Cross-sectional survey of new patients in the National Tuberculosis Programme (NTP). Retrospective assessment of health seeking and diagnostic procedures used by previously contacted health care providers. RESULTS: Four weeks after first symptom, 81% of patients had sought help outside the household. Four weeks after first health care contact, 47% had been diagnosed with TB. Private physicians used X-rays, sputum smears, and referrals significantly less often than public health care providers. Patients who had turned first to a private pharmacy, a private physician or a public hospital were significantly more likely to have a long provider delay than those who turned first to the NTP. CONCLUSION: Delay to diagnosis of TB in HCMC is due more to inability among health care providers to detect TB than to under-utilisation of health care services. Diagnostic procedures need to be improved and referral chains need to be strengthened in HCMC, particularly among private providers.
SETTING: Ho Chi Minh City (HCMC), Vietnam. OBJECTIVES: To describe delay to diagnosis; to compare diagnostic procedures and referral routines used by private and public health care providers; and to examine associations between contact with various types of providers and risk of delay to TB diagnosis. DESIGN: Cross-sectional survey of new patients in the National Tuberculosis Programme (NTP). Retrospective assessment of health seeking and diagnostic procedures used by previously contacted health care providers. RESULTS: Four weeks after first symptom, 81% of patients had sought help outside the household. Four weeks after first health care contact, 47% had been diagnosed with TB. Private physicians used X-rays, sputum smears, and referrals significantly less often than public health care providers. Patients who had turned first to a private pharmacy, a private physician or a public hospital were significantly more likely to have a long provider delay than those who turned first to the NTP. CONCLUSION: Delay to diagnosis of TB in HCMC is due more to inability among health care providers to detect TB than to under-utilisation of health care services. Diagnostic procedures need to be improved and referral chains need to be strengthened in HCMC, particularly among private providers.
Authors: E L N Maciel; J E Golub; R L Peres; D J Hadad; J L Fávero; L P Molino; J W Bae; C M Moreira; V do V Detoni; S A Vinhas; M Palaci; R Dietze Journal: Int J Tuberc Lung Dis Date: 2010-11 Impact factor: 2.373
Authors: Monty Liong; Anh N Hoang; Jaehoon Chung; Nil Gural; Christopher B Ford; Changwook Min; Rupal R Shah; Rushdy Ahmad; Marta Fernandez-Suarez; Sarah M Fortune; Mehmet Toner; Hakho Lee; Ralph Weissleder Journal: Nat Commun Date: 2013 Impact factor: 14.919
Authors: Anagha Pradhan; Karina Kielmann; Himanshu Gupte; Arun Bamne; John D H Porter; Sheela Rangan Journal: BMC Public Health Date: 2010-05-20 Impact factor: 3.295
Authors: Ndeindo Ndeikoundam Ngangro; Doudeadoum Ngarhounoum; Mosurel N Ngangro; Ngakoutou Rangar; Mahinda G Siriwardana; Virginie Halley des Fontaines; Pierre Chauvin Journal: BMC Public Health Date: 2012-07-09 Impact factor: 3.295