Perceptions of chest pain and healthcare seeking behavior for chest pain in northern Tanzania: A community-based survey

• Published in: PloS one 2019-02, Vol.14 (2), p.e0212139-e0212139
• Main Authors: Hertz, Julian T, Madut, Deng B, Tesha, Revogatus A, William, Gwamaka, Simmons, Ryan A, Galson, Sophie W, Sakita, Francis M, Maro, Venance P, Bloomfield, Gerald S, Crump, John A, Rubach, Matthew P
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Adolescent; Adult; Adults; Aged; Aged, 80 and over; Analysis; Behavior; Biology and Life Sciences; Cardiology; Cardiovascular disease; Chest; Chest pain; Chest Pain - psychology; Communities; Community; Decision making; Diabetes; Emergency medical care; Epidemiology; Ethics; Female; Females; Global positioning systems; GPS; Health aspects; Health care; Health care facilities; Health care policy; Health Knowledge, Attitudes, Practice; Heart; Heart attack; Heart attacks; Households; Humans; Hypertension; Immunization; Male; Males; Medical care; Medicine; Medicine and Health Sciences; Middle Aged; Myocardial infarction; Pain; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Patients; People and Places; Population; Population number; Principal components analysis; Social Sciences; Studies; Surveys and Questionnaires; Tanzania; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0212139

Little is known about community perceptions of chest pain and healthcare seeking behavior for chest pain in sub-Saharan Africa. A two-stage randomized population-based cluster survey with selection proportional to population size was performed in northern Tanzania. Self-identified household healthcare decision-makers from randomly selected households were asked to list all possible causes of chest pain in an adult and asked where they would go if an adult household member had chest pain. Of 718 respondents, 485 (67.5%) were females. The most commonly cited causes of chest pain were weather and exercise, identified by 342 (47.6%) and 318 (44.3%) respondents. Two (0.3%) respondents identified 'heart attack' as a possible cause of chest pain. A hospital was selected as the preferred healthcare facility for an adult with chest pain by 277 (38.6%) respondents. Females were less likely to prefer a hospital than males (OR 0.65, 95% CI 0.47-0.90, p = 0.008). There is little community awareness of cardiac causes of chest pain in northern Tanzania, and most adults reported that they would not present to a hospital for this symptom. There is an urgent need for educational interventions to address this knowledge deficit and guide appropriate care-seeking behavior.