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How did the TB patients reach DOTS services in Delhi? A study of patient treatment seeking behavior.

Kapoor SK, Raman AV, Sachdeva KS, Satyanarayana S - PLoS ONE (2012)

Bottom Line: The study showed that informal providers and retail chemists were the first point of contact and source of clinical advice for two-third of the patients, while the rest sought medical care from qualified providers directly.Most patients sought medical care from more than two providers, before being diagnosed as TB.Female TB patients and patients with extra-pulmonary TB had long mean duration between onset of symptoms to initiation of treatment (6.3 months and 8.4 months respectively).

View Article: PubMed Central - PubMed

Affiliation: Harrow Medical Centre, Noida, India. sunil_kapoor96@yahoo.com

ABSTRACT

Setting: Revised National Tuberculosis Control Programme (RNTCP), Delhi, India.

Objective: To ascertain the number and sequence of providers visited by TB patients before availing treatment services from DOTS; to describe the duration between onset of symptoms to treatment.

Study design: A cross sectional, qualitative study. Information was gathered through in-depth interviews of TB patients registered during the month of Oct, 2012 for availing TB treatment under the Revised National TB Control Programme from four tuberculosis diagnosis and treatment centers in Delhi.

Results: Out of the 114 patients who registered, 108 participated in the study. The study showed that informal providers and retail chemists were the first point of contact and source of clinical advice for two-third of the patients, while the rest sought medical care from qualified providers directly. Most patients sought medical care from more than two providers, before being diagnosed as TB. Female TB patients and patients with extra-pulmonary TB had long mean duration between onset of symptoms to initiation of treatment (6.3 months and 8.4 months respectively).

Conclusion: The pathways followed by TB patients, illustrated in this study, provide valuable lessons on the importance of different types of providers (both formal and informal) in the health system in a society like India and the delays in the diagnosis and treatment of tuberculosis.

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Related in: MedlinePlus

Pathway taken by patients to reach health facilities with RNTCP (DOTS) services in relation to the type of health care provider and frequency of consultation.
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getmorefigures.php?uid=PMC3412865&req=5

pone-0042458-g002: Pathway taken by patients to reach health facilities with RNTCP (DOTS) services in relation to the type of health care provider and frequency of consultation.

Mentions: Figure 2, illustrates the sequence of consultations held by the patients with various providers. Those who sought medical care from chemists finally went to qualified practitioner, but only after four rounds of consultations with informal providers or other chemists. Majority of the patients despite visiting the informal providers, moved to qualified practitioners eventually. This was apparent from the proportion of patients who had sought care from qualified practitioners after the third round of consultation with the informal providers. One-third of the patients who sought medical care from qualified providers went to DOTS directly after the 1st consultation, but others had visited qualified providers few more times (up to 6 times) before reaching a DOTS center.


How did the TB patients reach DOTS services in Delhi? A study of patient treatment seeking behavior.

Kapoor SK, Raman AV, Sachdeva KS, Satyanarayana S - PLoS ONE (2012)

Pathway taken by patients to reach health facilities with RNTCP (DOTS) services in relation to the type of health care provider and frequency of consultation.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3412865&req=5

pone-0042458-g002: Pathway taken by patients to reach health facilities with RNTCP (DOTS) services in relation to the type of health care provider and frequency of consultation.
Mentions: Figure 2, illustrates the sequence of consultations held by the patients with various providers. Those who sought medical care from chemists finally went to qualified practitioner, but only after four rounds of consultations with informal providers or other chemists. Majority of the patients despite visiting the informal providers, moved to qualified practitioners eventually. This was apparent from the proportion of patients who had sought care from qualified practitioners after the third round of consultation with the informal providers. One-third of the patients who sought medical care from qualified providers went to DOTS directly after the 1st consultation, but others had visited qualified providers few more times (up to 6 times) before reaching a DOTS center.

Bottom Line: The study showed that informal providers and retail chemists were the first point of contact and source of clinical advice for two-third of the patients, while the rest sought medical care from qualified providers directly.Most patients sought medical care from more than two providers, before being diagnosed as TB.Female TB patients and patients with extra-pulmonary TB had long mean duration between onset of symptoms to initiation of treatment (6.3 months and 8.4 months respectively).

View Article: PubMed Central - PubMed

Affiliation: Harrow Medical Centre, Noida, India. sunil_kapoor96@yahoo.com

ABSTRACT

Setting: Revised National Tuberculosis Control Programme (RNTCP), Delhi, India.

Objective: To ascertain the number and sequence of providers visited by TB patients before availing treatment services from DOTS; to describe the duration between onset of symptoms to treatment.

Study design: A cross sectional, qualitative study. Information was gathered through in-depth interviews of TB patients registered during the month of Oct, 2012 for availing TB treatment under the Revised National TB Control Programme from four tuberculosis diagnosis and treatment centers in Delhi.

Results: Out of the 114 patients who registered, 108 participated in the study. The study showed that informal providers and retail chemists were the first point of contact and source of clinical advice for two-third of the patients, while the rest sought medical care from qualified providers directly. Most patients sought medical care from more than two providers, before being diagnosed as TB. Female TB patients and patients with extra-pulmonary TB had long mean duration between onset of symptoms to initiation of treatment (6.3 months and 8.4 months respectively).

Conclusion: The pathways followed by TB patients, illustrated in this study, provide valuable lessons on the importance of different types of providers (both formal and informal) in the health system in a society like India and the delays in the diagnosis and treatment of tuberculosis.

Show MeSH
Related in: MedlinePlus