Nerges Mistry1, Eunice Lobo2, Shimoni Shah2, Sheela Rangan2, Yatin Dholakia2. 1. The Foundation for Medical Research, 84A, R.G. Thadani Marg, Worli, Mumbai 400018, India. Electronic address: fmr@fmrindia.org. 2. The Foundation for Medical Research, 84A, R.G. Thadani Marg, Worli, Mumbai 400018, India.
Abstract
BACKGROUND: Delays in accessing effective health care plays a pivotal role in increasing Tuberculosis (TB) transmission within the community. Patna, North India, with high levels of poverty and weak public health system, faces huge challenges for achieving effective TB control. The study aims to determine delays that occur from onset of TB symptoms until initiation of pulmonary TB (PTB) treatment among patients in Patna. METHODS: Of the 109 self-reporting TB patients identified through an active household survey, 64 PTB patients were interviewed. First care seeking, TB diagnostic and treatment initiation durations were calculated and delays defined for new and retreatment patients and minors and adults. Outliers exhibiting extreme delays were additionally identified. RESULTS: A cross sMean total pathway duration for TB care was 40days, with diagnostic duration contributing to 58% of the duration. No significant differences were noted between new and retreatment patients. Minors, comprising of 30% of total PTB patients accessed care faster than adults, but showed significantly higher diagnostic duration (38days vs. 17days). Preference for private sector, chemists and allopaths was seen throughout the pathway. DISCUSSION: Patna requires a more effective harnessing of the private sector augmented with reliable diagnostic investigations and a focus on quality.
BACKGROUND: Delays in accessing effective health care plays a pivotal role in increasing Tuberculosis (TB) transmission within the community. Patna, North India, with high levels of poverty and weak public health system, faces huge challenges for achieving effective TB control. The study aims to determine delays that occur from onset of TB symptoms until initiation of pulmonary TB (PTB) treatment among patients in Patna. METHODS: Of the 109 self-reporting TB patients identified through an active household survey, 64 PTB patients were interviewed. First care seeking, TB diagnostic and treatment initiation durations were calculated and delays defined for new and retreatment patients and minors and adults. Outliers exhibiting extreme delays were additionally identified. RESULTS: A cross sMean total pathway duration for TB care was 40days, with diagnostic duration contributing to 58% of the duration. No significant differences were noted between new and retreatment patients. Minors, comprising of 30% of total PTB patients accessed care faster than adults, but showed significantly higher diagnostic duration (38days vs. 17days). Preference for private sector, chemists and allopaths was seen throughout the pathway. DISCUSSION: Patna requires a more effective harnessing of the private sector augmented with reliable diagnostic investigations and a focus on quality.
Authors: Sachin R Atre; Jayshri D Jagtap; Mujtaba I Faqih; Yogita K Dumbare; Trupti U Sawant; Sunil L Ambike; Jitendra S Bhawalkar; Sandeep K Bharaswadkar; Padmaja K Jogewar; Ramji S Adkekar; Balasaheb P Hodgar; Vaishali Jadhav; Nitin D Mokashi; Jonathan E Golub; Avika Dixit; Maha R Farhat Journal: Am J Respir Crit Care Med Date: 2022-01-15 Impact factor: 21.405