Rural poverty and delayed presentation to tuberculosis services in Ethiopia

• Published in: Tropical medicine & international health 2005-04, Vol.10 (4), p.330-335
• Main Authors: Cambanis, Alexis, Yassin, Mohammed A., Ramsay, Andy, Bertel Squire, S., Arbide, Isabel, Cuevas, Luis E.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Bacterial diseases; Biological and medical sciences; Developing Countries; Ethiopia; Female; Health Services Accessibility; Human bacterial diseases; Humans; Infectious diseases; LDCs; Male; Medical sciences; Middle Aged; Mycobacterium tuberculosis; Patient Acceptance of Health Care; patient delay; Patients; Poverty; Risk Factors; Rural Health - statistics & numerical data; Rural health care; Socioeconomic Factors; socio‐economic factors; Time Factors; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis - psychology; Tuberculosis and atypical mycobacterial infections
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/j.1365-3156.2005.01393.x

Summary To measure time to initial presentation and assess factors influencing the decision to seek medical attention, we interviewed 243 patients undergoing sputum examination for the diagnosis of tuberculosis (TB) at a rural health centre near Awassa, Ethiopia. A structured questionnaire was used. Median (mean + SD) patient delay was 4.3 (9.8 + 12.4) weeks. Delays over 4 weeks were significantly associated with rural residence, transport time over 2 h, overnight travel, transport cost exceeding US$1.40, having sold personal assets prior to the visit, and use of traditional medicine. The majority of patients cited economic or logistical barriers to health care when asked directly about causes of delay. Case‐finding strategies for TB must be sensitive to patient delay and health systems must become more accessible in rural areas.