Patient characteristics, health seeking and delays among new sputum smear positive TB patients identified through active case finding when compared to passive case finding in India

Autor: Ajay M. V. Kumar, Gayadhar Mallick, Kamlesh Singh, Hemant Deepak Shewade, A. James Jeyakumar Jaisingh, Vaibhav Haribhau Ghule, Lakshmi Murali, Binod Kumar Srivastava, Sanjeeb Barik, Ramesh Singh, Srinath Satyanarayana, Manas Ranjan Singh Lohar, Prafulla Verma, Banuru Muralidhara Prasad, Ganesh Venkatraman, Kavita Sahai, Gurukartick Jayaraman, Karuna D. Sagili, Naresh Kumar, Vivek Gupta, Soundappan Kathirvel, Om Prakash Bera, Ali Jafar Naqvi, Jinesh Lal, Subrat Mohanty, Ashwini Kumar Sharma, Chandrashekhar S. Gaurkhede, Raghuram Rao, Prabhat Pandey, Sharifa Yasin Bale, Ishwar Koli, Sripriya Pandurangan, U N Bajpai, Sudhi Nath, Ashwin Kumar Bharadwaj, Mohammed Salauddin Ansari, Madhav Deshpande, Sanjeev Kamble, Sunil Kumar, Moumita Biswas, Priyanka Singh, P. Rajeswaran, Kulathu Iyer Sathiyanarayanan, Ganesh Parate, Vijesh Mathew, G Sumesh, Jaya Prasad Tripathy, Sarabjit Chadha, Prafulla C. Mishra
Rok vydání: 2019
Předmět:
Bacterial Diseases
Male
0301 basic medicine
Delayed Diagnosis
Medical Doctors
National Health Programs
Physiology
Health Care Providers
Patient advocacy
Geographical Locations
0302 clinical medicine
Weight loss
Medicine and Health Sciences
Mass Screening
Medical Personnel
030212 general & internal medicine
Young adult
Multidisciplinary
Confounding
Middle Aged
Body Fluids
Professions
Infectious Diseases
Tuberculosis Diagnosis and Management
Medicine
Female
Anatomy
medicine.symptom
Research Article
Adult
medicine.medical_specialty
Asia
Tuberculosis
Adolescent
Science
030106 microbiology
India
Patient Advocacy
Vulnerable Populations
Time-to-Treatment
Young Adult
03 medical and health sciences
Diagnostic Medicine
Internal medicine
medicine
Humans
Tuberculosis
Pulmonary

Mass screening
Aged
business.industry
Sputum
Biology and Life Sciences
Patient Acceptance of Health Care
Tropical Diseases
medicine.disease
Health Care
Mucus
People and Places
Population Groupings
Observational study
business
Zdroj: PLoS ONE, Vol 14, Iss 3, p e0213345 (2019)
PLoS ONE
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0213345
Popis: BackgroundAxshya SAMVAD is an active tuberculosis (TB) case finding (ACF) strategy under project Axshya (Axshya meaning 'free of TB' and SAMVAD meaning 'conversation') among marginalized and vulnerable populations in 285 districts of India.ObjectivesTo compare patient characteristics, health seeking, delays in diagnosis and treatment initiation among new sputum smear positive TB patients detected through ACF and passive case finding (PCF) under the national TB programme in marginalized and vulnerable populations between March 2016 and February 2017.MethodsThis observational analytic study was conducted in 18 randomly sampled Axshya districts. We enrolled all TB patients detected through ACF and an equal number of randomly selected patients detected through PCF in the same settings. Data on patient characteristics, health seeking and delays were collected through record review and patient interviews (at their residence). Delays included patient level delay (from eligibility for sputum examination to first contact with any health care provider (HCP)), health system level diagnosis delay (from contact with first HCP to TB diagnosis) and treatment initiation delays (from diagnosis to treatment initiation). Total delay was the sum of patient level, health system level diagnosis delay and treatment initiation delays.ResultsWe included 234 ACF-diagnosed and 231 PCF-diagnosed patients. When compared to PCF, ACF patients were relatively older (≥65 years, 14% versus 8%, p = 0.041), had no formal education (57% versus 36%, pConclusionAxshya SAMVAD linked the most impoverished communities to TB care and resulted in reduction of health system level diagnosis delay.
Databáze: OpenAIRE