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 |
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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 |
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