Delay in diagnosis and treatment among registered TB patients in Directly Observed Treatment Short Course cum Designated Microscopy Centres in South Delhi

Authors

  • Arunraj Kamaraj Lady Hardinge Medical College, New Delhi https://orcid.org/0000-0002-0238-6264
  • Manish Kumar Goel Lady Hardinge Medical College, New Delhi
  • Jyoti Khandekar Lady Hardinge Medical College, New Delhi
  • Khalid Umer Khayyam National Institute of TB & Respiratory Diseases, Delhi https://orcid.org/0000-0002-4186-5399
  • Sanjeev Kumar Rasania Lady Hardinge Medical College, New Delhi

DOI:

https://doi.org/10.47203/IJCH.2021.v33i02.021

Keywords:

Tuberculosis, RNTCP, Patients Delay, Health Care System Delay

Abstract

Background: Knowing delays in treatment seeking and subsequent treatment initiation among the TB patients is important and its detailed understanding is crucial in modifying the treatment seeking behaviour which can help in reducing the TB burden and the transmission in the community. Aim & Objective: To study the treatment seeking behaviour including the delays in initiation of treatment along with its determinants; among tuberculosis patients aged > 15 years in Mehrauli area of Delhi. Settings and Design: A longitudinal follow up study conducted in two randomly selected DMC cum DOTS centres in Mehrauli area of Delhi from January 2018 to April 2018. Methods and Material: Patients of both sexes of age > 15 years, registered under RNTCP from January to April 2018 in the randomly selected DOTS centres i.e. Mehrauli DMC cum DOTS and Chattarpur DMC cum DOTS centre were included in the study. Self-designed, pretested interview schedule and records of DMC were used to collect the relevant information. Statistical analysis used: Information collected in the Performa was coded and entered in Statistical Package for Social Sciences (SPSS) version 12. Results: The mean patients delay, diagnostic delay, treatment delay, health care system delay and total delay was 48.91 ± 130.38 days, 91.09 ± 155.97 days, 6.25 ± 6.29 days, 62.72 ± 119.48 days and 97.33 ± 155.06 days respectively. The median patients delay, diagnostic delay, treatment delay, health care system delay and total delay was 15 days, 45 days, 5 days, 35 days and 54 days respectively. Conclusions: The major reasons for patient’s delay were lack of awareness regarding the symptoms of TB and self-medication and for health care system delay it was treatment from private health care providers.

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References

Sreeramareddy CT, Qin ZZ, Satyanarayana S, Subbaraman R, Pai M. Delays in diagnosis and treatment of pulmonary tuberculosis in India: a systematic review. Int J Tubercul Lung Dis. 2014;18:255-66.

Yimer S, Holm-Hansen C, Yimaldu T, Bjune G. Health care seeking among pulmonary tuberculosis suspects and patients in rural Ethiopia: a community-based study. BMC public health.2009;9:454.

SaMal J. Health Seeking Behaviour among Tuberculosis Patients in India: A Systematic Review. J Clin Diagn Res.2016;10(10):LE01.

Revised National TB Control Programme (RNTCP) National Strategic Plan for Tuberculosis Elimination 2017–2025. New Delhi, India: Central TB Division Government of India; 2017 Mar: 6.

Kaur G, Goel NK, Kumar D, Janmeja AK, Swami HM, Kalia M. Treatment outcomes of patients placed on treatment under directly observed therapy short-course (dots). Lung India. 2008;25(2):75-7.

Jain M, Swarnkar M, Mehta SC, Kumar V. Evaluation study of treatment outcome in Tuberculosis patients receiving DOTS under RNTCP. Indian J Community Health. 2016;28(4):352-8.

Kulkarni PY, Kulkarni AD, Akarte SV, Bhawalkar JS, Khedkar DT. Treatment seeking behaviour and related delays by pulmonary TB patients in E-ward of Mumbai Municipal Corporation, India. Int J Med Public Health. 2013; 3:286-92.

WHO. Diagnostic and treatment delay in tuberculosis. An in-depth analysis of the health-seeking behaviour of patients and health system response in seven countries of the Eastern Mediterranean Region. Cairo: World Health Organization; 2006;14.

Selvam J M, Wares F, Perumal M, Gopi P G, Sudha G, Chandrasekaran V, et al. Health-seeking behaviour of new smear-positive TB patients under a DOTS programme in Tamil Nadu, India, 2003. Int J Tuberc Lung Dis. 2007; 11: 161–67.

Nimbarte SB, Wagh V, Selokar D. Health seeking behaviour among pulmonary TB patients in rural part of central India. Int J Biol Med Res. 2011;2:394-97.

Ananthakrishnan R, Jeyaraju A R, Palani G, Sathiyasekaran BWC. Care seeking behaviour of the TB patients who were registered in an urban government TB Control in Chennai, Tamilnadu, India. J Clin Diagn Res. 2012; 6:990-93.

Qureshi SA, Morkve O, Mustafa T. Patient and health system delays: health-care seeking behaviour among pulmonary tuberculosis patients in Pakistan. JPMA. J Pak Med Assoc. 2008; 58:318.

Kapoor SK, Raman AV, Sachdeva KS, Satyanarayana S. How did the TB patients reach DOTS services in Delhi? A study of patient treatment seeking behavior. PLoS one. 2012; 7:e42458.

Tamhane A, Ambe G, Vermund SH, Kohler CL, Karande A, Sathiakumar N. Pulmonary tuberculosis in Mumbai, India: factors responsible for patient and treatment delays. Int J Prev Med. 2012; 3:569.

Maamari F. Case-finding tuberculosis patients: diagnostic and treatment delays and their determinants. East Mediterr Health J 2008; 14:531-45.

Belay M, Bjune G, Ameni G, Abebe F. Diagnostic and treatment delay among Tuberculosis patients in Afar Region, Ethiopia: a cross-sectional study. BMC Public Health. 2012; 12:369.

Selvam Paramasivam BT, Chandran P, Thayyil J, George B, Sivakumar CP. Diagnostic delay and associated factors among patients with pulmonary tuberculosis in Kerala. J Family Med Prim Care. 2017; 6:643.

Behera BK, Jain RB, Gupta KB, Goel MK. Extent of delay in diagnosis in new smear positive patients of pulmonary tuberculosis attending tertiary care hospital. Int J Prev Med. 2013; 4:1480.

Hussen A, Biadgilign S, Tessema F, Mohammed S, Deribe K, Deribew A. Treatment delay among pulmonary tuberculosis patients in pastoralist communities in Bale Zone, Southeast Ethiopia. BMC Res Notes. 2012; 5:320.

Van Wyk SS, Enarson DA, Beyers N, Lombard C, Hesseling AC. Consulting private health care providers aggravates treatment delay in urban South African tuberculosis patients. Int J Tuberc Lung Dis. 2011; 15:1069-76.

Zerbini E, Chirico MC, Salvadores B, Amigot B, Estrada S, Algorry G. Delay in tuberculosis diagnosis and treatment in four provinces of Argentina. Int J Tuberc Lung Dis. 2008; 12:63-8.

Karanjekar VD, Gujarathi VV, Lokare PO. Socio demographic factors associated with health seeking behaviour of chest symptomatics in urban slums of Aurangabad city, India. Int J App Basic Med Res. 2014; 4:173-79.

Kulkarni PY, Kulkarni AD, Akarte SV, Bhawalkar JS, Khedkar DT. Treatment seeking behaviour and related delays by pulmonary TB patients in E-ward of Mumbai Municipal Corporation, India. Int J Med Public Health. 2013; 3:286-92.

Charles N, Thomas B, Watson B, Chandrasekeran V, Wares F. Care seeking behaviour of chest symptomatics: a community based study done in South India after the implementation of the RNTCP. PloS one. 2010; 5:e12379.

Meyssonnier V, Li X, Shen X, Wang H, Li DY, Liu ZM, Liu G, Mei J, Gao Q. Factors associated with delayed tuberculosis diagnosis in China. Eur J Public Health. 2013;23(2):253-7.

Thakur R, Murhekar M. Delay in diagnosis and treatment among TB patients registered under RNTCP Mandi, Himachal Pradesh, India, 2010. Indian J Tuberc. 2013;60(1):37-45

Saqib MA, Awan IN, Rizvi SK, Shahzad MI, Mirza ZS, Tahseen S, Khan IH, Khanum A. Delay in diagnosis of tuberculosis in Rawalpindi, Pakistan. BMC Res Notes. 2011;26(4):165. doi: 10.1186/1756-0500-4-165. PMID: 21615946; PMCID: PMC3123219.

Aye R, Wyss K, Abdualimova H, Saidaliev S. Patient's site of first access to health system influences length of delay for tuberculosis treatment in Tajikistan. BMC Health Serv Res. 2010; 10:10.

Ukwaja KN, Alobu I, Nweke CO, Onyenwe EC. Healthcare-seeking behavior, treatment delays and its determinants among pulmonary tuberculosis patients in rural Nigeria: a cross-sectional study. BMC Health Serv Res. 2013; 13:25.

Gele AA, Bjune G, Abebe F. Pastoralism and delay in diagnosis of TB in Ethiopia. BMC Public Health. 2009; 9:5.

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Published

2021-06-30

How to Cite

1.
Kamaraj A, Goel MK, Khandekar J, Khayyam KU, Rasania SK. Delay in diagnosis and treatment among registered TB patients in Directly Observed Treatment Short Course cum Designated Microscopy Centres in South Delhi. Indian J Community Health [Internet]. 2021 Jun. 30 [cited 2024 Jun. 13];33(2):344-50. Available from: https://www.iapsmupuk.org/journal/index.php/IJCH/article/view/2008

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