Pulmonary TB in Patna, India: Durations, delays, and health care seeking behaviour among patients identified through household surveys
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 40 days, 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
(38 days vs. 17 days). 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.
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