Siddabathula, Harika (2016) Factors affecting delay in early diagnosis and initiation of treatment for tuberculosis in Vellore District, Tamil Nadu. Masters thesis, Christian Medical College, Vellore.
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Abstract
Tuberculosis is the leading killer, affecting adults in the developing countries. Estimates suggest that an untreated, smear positive patient can infect, on an average10 contacts annually and more than 20 during the course of the disease. A delay in TB diagnosis may lead to more advanced disease state at presentation. Late-stage presentation may contribute to a poor response to treatment, resulting in more severe morbidity while increasing the risk of transmission. It is important to identify the causes of such delays to efficiently take measures to achieve target of case detection and elimination. Methods: The present study is a cross sectional study. The main objectives of this study were to find the average delay in diagnosis/treatment in TB and to identify the determinants of delay in treatment seeking including perceived stigma. The study is done among the newly diagnosed sputum positive tuberculosis patients who were registered in the Tuberculosis Unit run by the Community Health Department of Christian Medical College, Vellore. After obtaining informed consent, study participants were interviewed by the investigator using a structured questionnaire. To study the level of perceived stigma related to Tuberculosis, 100 people from rural area were interviewed. Data was entered using Epidata and analysis was done using SPSS. Results with conclusions: We included 95 patients with TB and 100 from general population to know stigma in community. The mean total delay from the onset of disease to initiation of treatment was 104.8 days. The patient delay, health system delay, centre delay and treatment delay were 38.5, 99.3, 60.8 and 2 days respectively. The median total delay, patient delay, health system delay, centre delay and treatment delay were 91, 20, 90, 16, and 2 days respectively. Participants with TB were found to have more perception of stigma (p=<0.001.OR=7.19). Among the general population, participants with good knowledge had more perception of stigma (OR=2.40, P=0.003). Other factors that were independently associated with delay were low SES (P=0.03, OR=2.77) and more number of health centres visited (p=<0.001, OR= 5.682). In order to minimize the level of perceived stigma related to TB and to improve early health seeking, awareness should be created in the general population regarding the transmission of TB. Awareness need to be created on complications of not treating early and the high cure rate with early treatment and the type of health facility where screening can be done. From this study it is imperative that the local medical practitioners should be motivated to screen for Tuberculosis at the first onset of symptoms. Frequent continuing medical education sessions may improve case finding and minimize the delay. As most people choose to go to private practitioners for the chest symptom, more diagnostic facility to test sputum should be made available.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Early Diagnosis and Initiation ; Tuberculosis ; Vellore. |
| Subjects: | MEDICAL > Community Medicine |
| Depositing User: | Punitha K |
| Date Deposited: | 25 Jul 2017 09:16 |
| Last Modified: | 02 Mar 2018 16:44 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2149 |
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