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Treatment delay among tuberculosis patients in Tanzania: Data from the FIDELIS Initiative

BACKGROUND: Several FIDELIS projects (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) in Tanzania were conducted by the National Tuberculosis and Leprosy Programme (NTLP) during the years 2004-2008 to strengthen diagnostic and treatment services. These projects collected inf...

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Autores principales: Hinderaker, Sven Gudmund, Madland, Simon, Ullenes, Martin, Enarson, Donald A, Rusen, ID, Kamara, Deudatus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3115859/
https://www.ncbi.nlm.nih.gov/pubmed/21569434
http://dx.doi.org/10.1186/1471-2458-11-306
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author Hinderaker, Sven Gudmund
Madland, Simon
Ullenes, Martin
Enarson, Donald A
Rusen, ID
Kamara, Deudatus
author_facet Hinderaker, Sven Gudmund
Madland, Simon
Ullenes, Martin
Enarson, Donald A
Rusen, ID
Kamara, Deudatus
author_sort Hinderaker, Sven Gudmund
collection PubMed
description BACKGROUND: Several FIDELIS projects (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) in Tanzania were conducted by the National Tuberculosis and Leprosy Programme (NTLP) during the years 2004-2008 to strengthen diagnostic and treatment services. These projects collected information on treatment delay and some of it was available for research purposes. With this database our objective was to assess the duration and determinants of treatment delay among new smear positive pulmonary tuberculosis (TB) patients in FIDELIS projects, and to compare delay according to provider visited prior to diagnosis. METHODS: Treatment delay among new smear positive TB patients was recorded for each patient at treatment initiation and this information was available and fairly complete in 6 out of 57 districts with FIDELIS projects enrolling patients between 2004 and 2007; other districts had discarded their forms at the time of analysis. It was analysed as a cross sectional study. RESULTS: We included 1161 cases, 10% of all patients recruited in the FIDELIS projects in Tanzania. Median delay was 12 weeks. The median duration of cough, weight loss and haemoptysis was 12, 8 and 3 weeks, respectively. Compared to Hai district Handeni had patients with longer delays and Mbozi had patients with shorter delays. Urban and rural patients reported similar delays. Patients aged 15-24 years and patients of 65 years or older had longer delays. Patients reporting contact with traditional healers before diagnosis had a median delay of 15 weeks compared to 12 weeks among those who did not. Patients with dyspnoea and with diarrhoea had longer delays. CONCLUSION: In this patient sample in Tanzania half of the new smear positive pulmonary tuberculosis patients had a treatment delay longer than 12 weeks. Delay was similar in men and women and among urban and rural patients, but longer in the young and older age groups. Patients using traditional healers had a 25% longer median delay.
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spelling pubmed-31158592011-06-16 Treatment delay among tuberculosis patients in Tanzania: Data from the FIDELIS Initiative Hinderaker, Sven Gudmund Madland, Simon Ullenes, Martin Enarson, Donald A Rusen, ID Kamara, Deudatus BMC Public Health Research Article BACKGROUND: Several FIDELIS projects (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) in Tanzania were conducted by the National Tuberculosis and Leprosy Programme (NTLP) during the years 2004-2008 to strengthen diagnostic and treatment services. These projects collected information on treatment delay and some of it was available for research purposes. With this database our objective was to assess the duration and determinants of treatment delay among new smear positive pulmonary tuberculosis (TB) patients in FIDELIS projects, and to compare delay according to provider visited prior to diagnosis. METHODS: Treatment delay among new smear positive TB patients was recorded for each patient at treatment initiation and this information was available and fairly complete in 6 out of 57 districts with FIDELIS projects enrolling patients between 2004 and 2007; other districts had discarded their forms at the time of analysis. It was analysed as a cross sectional study. RESULTS: We included 1161 cases, 10% of all patients recruited in the FIDELIS projects in Tanzania. Median delay was 12 weeks. The median duration of cough, weight loss and haemoptysis was 12, 8 and 3 weeks, respectively. Compared to Hai district Handeni had patients with longer delays and Mbozi had patients with shorter delays. Urban and rural patients reported similar delays. Patients aged 15-24 years and patients of 65 years or older had longer delays. Patients reporting contact with traditional healers before diagnosis had a median delay of 15 weeks compared to 12 weeks among those who did not. Patients with dyspnoea and with diarrhoea had longer delays. CONCLUSION: In this patient sample in Tanzania half of the new smear positive pulmonary tuberculosis patients had a treatment delay longer than 12 weeks. Delay was similar in men and women and among urban and rural patients, but longer in the young and older age groups. Patients using traditional healers had a 25% longer median delay. BioMed Central 2011-05-12 /pmc/articles/PMC3115859/ /pubmed/21569434 http://dx.doi.org/10.1186/1471-2458-11-306 Text en Copyright ©2011 Hinderaker et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Hinderaker, Sven Gudmund
Madland, Simon
Ullenes, Martin
Enarson, Donald A
Rusen, ID
Kamara, Deudatus
Treatment delay among tuberculosis patients in Tanzania: Data from the FIDELIS Initiative
title Treatment delay among tuberculosis patients in Tanzania: Data from the FIDELIS Initiative
title_full Treatment delay among tuberculosis patients in Tanzania: Data from the FIDELIS Initiative
title_fullStr Treatment delay among tuberculosis patients in Tanzania: Data from the FIDELIS Initiative
title_full_unstemmed Treatment delay among tuberculosis patients in Tanzania: Data from the FIDELIS Initiative
title_short Treatment delay among tuberculosis patients in Tanzania: Data from the FIDELIS Initiative
title_sort treatment delay among tuberculosis patients in tanzania: data from the fidelis initiative
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3115859/
https://www.ncbi.nlm.nih.gov/pubmed/21569434
http://dx.doi.org/10.1186/1471-2458-11-306
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