Time to care-seeking for TB symptoms-Reference-Cited by-同舟云学术

Time to care-seeking for TB symptoms

Published:2022-03-01 Issue:3 Volume:26 Page:268-275
ISSN:1027-3719
Container-title:The International Journal of Tuberculosis and Lung Disease
language:en
Short-container-title:int j tuberc lung dis

Author:

Mmolawa L.¹,Siwelana T.¹,Hanrahan C. F.²,Lebina L.¹,Martinson N. A.³,Dowdy D.⁴,Nonyane B. A. S.⁵

Affiliation:

1. Perinatal HIV Research Unit, South Africa Medical Research Council Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa

2. Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

3. Perinatal HIV Research Unit, South Africa Medical Research Council Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa, Johns Hopkins University, Center for TB Research, Baltimore, MD, USA

4. Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, Johns Hopkins University, Center for TB Research, Baltimore, MD, USA

5. Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, Perinatal HIV Research Unit, South Africa Medical Research Council Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa

Abstract

BACKGROUND: Early presentation to healthcare facilities is critical for early diagnosis and treatment of TB. We studied self-reported time to care-seeking from the onset of TB symptoms among primary healthcare clinic (PHC) attendees in Limpopo Province, South Africa.METHODS: We used data from participants enrolled in a cluster-randomized trial of TB case finding in 56 PHC clinics across two health districts. We fitted log-normal accelerated failure time regression models and we present time ratios (TRs) for potential risk factors.RESULTS: We included 2,160 participants. Among the 1,757 (81%) diagnosed with active TB, the median time to care-seeking was 30 days (IQR 14–60); adults sought care later than children/adolescents (adjusted TR aTR 1.47, 95% CI 1.10–1.96). Among those not diagnosed with TB, the median was 14 days (IQR 7–60); being HIV-positive (aTR 1.57, 95% CI 1.03–2.40); having less than grade 8 education and currently smoking were associated with longer time to care-seeking. In the combined analysis, living with HIV and having underlying active TB was associated with faster care-seeking (TB status x HIV interaction: TR 0.68, 95% CI 0.48–0.96).CONCLUSION: Delay in care-seeking was associated with age, lower education and being a current smoker. TB awareness campaigns targeting these population groups may improve care-seeking behavior and reduce community TB transmission.

Publisher

International Union Against Tuberculosis and Lung Disease

Subject

Infectious Diseases,Pulmonary and Respiratory Medicine

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