Time to Care-seeking for TB Symptoms

Overview

Journal Int J Tuberc Lung Dis

Specialty Pulmonary Medicine

Date 2022 Feb 24

PMID 35197167

Authors

L Mmolawa

T Siwelana

C F Hanrahan

L Lebina

N A Martinson

D Dowdy

B A S Nonyane

Affiliations

Soon will be listed here.

Abstract

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. 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. 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). 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.

Citing Articles

HIGH-RESOLUTION CHARACTERIZATION OF NOSOCOMIAL MYCOBACTERIUM TUBERCULOSIS TRANSMISSION EVENTS IN BOTSWANA.

Smith J, Modongo C, Oeltmann J, Dima M, Matsiri O, Fane O Am J Epidemiol. 2022; 192(3):503-506.

PMID: 36549903 PMC: 10372855. DOI: 10.1093/aje/kwac214.

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