Time to care-seeking for TB symptoms

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 partic...

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Bibliographic Details
Published in:The international journal of tuberculosis and lung disease 2022-03, Vol.26 (3), p.268-275
Main Authors: Mmolawa, L., Siwelana, T., Hanrahan, C. F., Lebina, L., Martinson, N. A., Dowdy, D., Nonyane, B. A. S.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Ambulatory Care Facilities
Child
Delayed Diagnosis
Early Diagnosis
HIV and TB comorbidities
Humans
Patient Acceptance of Health Care
Risk Factors
South Africa - epidemiology
Tb Symptoms
Time To Care-Seeking
Tuberculosis - diagnosis
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Summary: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.
ISSN:1027-3719
1815-7920
DOI:10.5588/ijtld.21.0447