Healthcare seeking patterns for TB symptoms: Findings from the first national TB prevalence survey of South Africa, 2017-2019.

Autor: Moyo S; Human Sciences Research Council, Cape Town, South Africa.; School of Public Health and Family, University of Cape Town, Cape Town, South Africa., Ismail F; National Institute for Communicable Diseases Division of the National Health Laboratory Services, Johannesburg, South Africa.; Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa., Mkhondo N; Tuberculosis Programme, World Health Organization, Pretoria, South Africa., van der Walt M; South African Medical Research Council, Pretoria, South Africa., Dlamini SS; National Department of Health, Pretoria, South Africa., Mthiyane T; South African Medical Research Council, Pretoria, South Africa., Naidoo I; Human Sciences Research Council, Cape Town, South Africa., Zuma K; Human Sciences Research Council, Cape Town, South Africa., Tadolini M; Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy., Law I; Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland., Mvusi L; National Department of Health, Pretoria, South Africa.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Mar 15; Vol. 18 (3), pp. e0282125. Date of Electronic Publication: 2023 Mar 15 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0282125
Abstrakt: Background: Although tuberculosis (TB) symptoms have limited sensitivity they remain an important entry point into the TB care cascade.
Objectives: To investigate self-reported healthcare seeking for TB symptoms in participants in a community-based survey.
Methods: We compared reasons for not seeking care in participants reporting ≥1 of four TB screening symptoms (cough, weight loss, night sweats, fever) in the first South African national TB prevalence survey (2017-2019). We used logistic regression analyses to identify sociodemographic and clinical characteristics associated with healthcare seeking.
Results: 5,168/35,191 (14.7%) survey participants reported TB symptoms and 3,442/5168 had not sought healthcare. 2,064/3,442(60.0%) participants intended to seek care, 912 (26.5%) regarded symptoms as benign, 399 (11.6%) reported access barriers(distance and cost), 36 (1.0%) took other medications and 20(0.6%) reported health system barriers. Of the 57/98 symptomatic participants diagnosed with bacteriologically confirmed TB who had not sought care: 38(66.7%) intended to do so, 8(14.0%) regarded symptoms as benign, and 6(10.5%) reported access barriers. Among these 98, those with unknown HIV status(OR 0.16 95% CI 0.03-0.82), p = 0.03 and those who smoked tobacco products(OR 0.39, 95% CI 0.17-0.89, p = 0.03) were significantly less likely to seek care.
Conclusions: People with TB symptoms delayed seeking healthcare, many regarded symptoms as benign while others faced access barriers. Those with unknown HIV status were significantly less likely to seek care. Strengthening community-based TB awareness and screening programmes together with self-screening models could increase awareness of the significance of TB symptoms and contribute to improving healthcare seeking and enable many people with TB to enter the TB care cascade.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Moyo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje