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Abstract
BackgroundReducing delay to accessing care is necessary to reduce the Tuberculosis (TB) burden in high incidence countries such as India. This study aimed to identify factors associated with delays in seeking care for TB in Southern India.MethodsWe analyzed data from newly diagnosed, smear-positive, culture-confirmed, pulmonary TB patients in the Regional Prospective Observational Research for TB (RePORT) cohort in Puducherry and Tamil Nadu, India. Data were collected on demographic characteristics, symptom duration, and TB knowledge, among other factors. Delay was defined as cough ≥4 weeks before treatment initiation. Risky alcohol use was defined by the AUDIT-C score which incorporates information about regular alcohol use and binge drinking. TB knowledge was assessed by knowing transmission mode or potential curability.ResultsOf 501 TB patients, 369 (73.7%) subjects delayed seeking care. In multivariable analysis, risky alcohol use was significantly associated with delay (aOR 2.20, 95% CI: 1.31, 3.68). Delay was less likely in lower versus higher income groups (<3000 versus >10,000 rupees/month, aOR 0.31, 95% CI: 0.12, 0.78). TB knowledge was not significantly associated with delay.ConclusionsLocal TB programs should consider that risky alcohol users may delay seeking care for TB. Further studies will be needed to determine why patients with higher income delay in seeking care.
Highlights
Reducing delay to accessing care is necessary to reduce the Tuberculosis (TB) burden in high incidence countries such as India
All new smear-positive patients are recruited from the 132 selected Revised National TB Control Programme (RNTCP) designated microscopy centers (DMCs) and primary healthcare centers (PHCs) that are closest to Puducherry and see a large number of TB cases, out of a total of 305 centers
Socio-demographic characteristics Overall, 656 TB patients who met study inclusion criteria were reported by the PHCs and DMCs from May 1, 2014 through July 27, 2016; of these, 638 (97%) were able to be located and were contacted regarding study enrollment
Summary
Reducing delay to accessing care is necessary to reduce the Tuberculosis (TB) burden in high incidence countries such as India. This study aimed to identify factors associated with delays in seeking care for TB in Southern India. There have been several studies in India of predictors of delay in seeking care, results have been. Patients can obtain healthcare through public and private clinics or a mix of both. The Revised National TB Control Programme (RNTCP) offers free TB diagnosis and treatment to patients in public clinics [17]. A recent study found that more than a quarter of prevalent TB patients are never evaluated at RNTCP clinics [18] and review of drug
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