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Pulmonary tuberculosis diagnostic delays in Chad: a multicenter, hospital-based survey in Ndjamena and Moundou

BACKGROUND: Tuberculosis remains one of the leading causes of morbidity and mortality in low-resource countries. One contagious patient can infect 10 to 20 contacts in these settings. Delays in diagnosing TB therefore contribute to the spread of the disease and sustain the epidemic. OBJECTIVES: The...

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Autores principales: Ngangro, Ndeindo Ndeikoundam, Ngarhounoum, Doudeadoum, Ngangro, Mosurel N, Rangar, Ngakoutou, Siriwardana, Mahinda G, des Fontaines, Virginie Halley, Chauvin, Pierre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519715/
https://www.ncbi.nlm.nih.gov/pubmed/22776241
http://dx.doi.org/10.1186/1471-2458-12-513
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author Ngangro, Ndeindo Ndeikoundam
Ngarhounoum, Doudeadoum
Ngangro, Mosurel N
Rangar, Ngakoutou
Siriwardana, Mahinda G
des Fontaines, Virginie Halley
Chauvin, Pierre
author_facet Ngangro, Ndeindo Ndeikoundam
Ngarhounoum, Doudeadoum
Ngangro, Mosurel N
Rangar, Ngakoutou
Siriwardana, Mahinda G
des Fontaines, Virginie Halley
Chauvin, Pierre
author_sort Ngangro, Ndeindo Ndeikoundam
collection PubMed
description BACKGROUND: Tuberculosis remains one of the leading causes of morbidity and mortality in low-resource countries. One contagious patient can infect 10 to 20 contacts in these settings. Delays in diagnosing TB therefore contribute to the spread of the disease and sustain the epidemic. OBJECTIVES: The aim of this study was to assess delays in diagnosing tuberculosis and the factors associated with these delays in the public hospitals in Moundou and Ndjamena, Chad. METHODS: A structured questionnaire was administered to 286 new tuberculosis patients to evaluate patient delay (time from the onset of symptoms to the first formal or informal care), health-care system delay (time from the first health care to tuberculosis treatment) and total delay (sum of the patient and system delays). Logistic regression was used to identify risk factors associated with long diagnostic delays (defined as greater than the median). RESULTS AND DISCUSSION: The median [interquartile range] patient delay, system delay and total delay were 15 [7–30], 36 [19–65] and 57.5 [33–95] days, respectively. Low economic status (aOR [adjusted odds ratio] =2.38 [1.08-5.25]), not being referred to a health service (aOR = 1.75 [1.02- 3.02]) and a secondary level education (aOR = 0.33 [0.12-0.92]) were associated with a long patient delay. Risk factors for a long system delay were a low level of education (aOR = 4.71 [1.34-16.51]) and the belief that traditional medicine and informal care can cure TB (aOR = 5.46 [2.37-12.60]). CONCLUSION: Targeted strengthening of the health-care system, including improving patient access, addressing deficiencies in health-related human resources, and improving laboratory networks and linkages as well as community mobilization will make for better outcomes in tuberculosis diagnosis.
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spelling pubmed-35197152012-12-12 Pulmonary tuberculosis diagnostic delays in Chad: a multicenter, hospital-based survey in Ndjamena and Moundou Ngangro, Ndeindo Ndeikoundam Ngarhounoum, Doudeadoum Ngangro, Mosurel N Rangar, Ngakoutou Siriwardana, Mahinda G des Fontaines, Virginie Halley Chauvin, Pierre BMC Public Health Research Article BACKGROUND: Tuberculosis remains one of the leading causes of morbidity and mortality in low-resource countries. One contagious patient can infect 10 to 20 contacts in these settings. Delays in diagnosing TB therefore contribute to the spread of the disease and sustain the epidemic. OBJECTIVES: The aim of this study was to assess delays in diagnosing tuberculosis and the factors associated with these delays in the public hospitals in Moundou and Ndjamena, Chad. METHODS: A structured questionnaire was administered to 286 new tuberculosis patients to evaluate patient delay (time from the onset of symptoms to the first formal or informal care), health-care system delay (time from the first health care to tuberculosis treatment) and total delay (sum of the patient and system delays). Logistic regression was used to identify risk factors associated with long diagnostic delays (defined as greater than the median). RESULTS AND DISCUSSION: The median [interquartile range] patient delay, system delay and total delay were 15 [7–30], 36 [19–65] and 57.5 [33–95] days, respectively. Low economic status (aOR [adjusted odds ratio] =2.38 [1.08-5.25]), not being referred to a health service (aOR = 1.75 [1.02- 3.02]) and a secondary level education (aOR = 0.33 [0.12-0.92]) were associated with a long patient delay. Risk factors for a long system delay were a low level of education (aOR = 4.71 [1.34-16.51]) and the belief that traditional medicine and informal care can cure TB (aOR = 5.46 [2.37-12.60]). CONCLUSION: Targeted strengthening of the health-care system, including improving patient access, addressing deficiencies in health-related human resources, and improving laboratory networks and linkages as well as community mobilization will make for better outcomes in tuberculosis diagnosis. BioMed Central 2012-07-09 /pmc/articles/PMC3519715/ /pubmed/22776241 http://dx.doi.org/10.1186/1471-2458-12-513 Text en Copyright ©2012 Ndeikoundam Ngangro 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
Ngangro, Ndeindo Ndeikoundam
Ngarhounoum, Doudeadoum
Ngangro, Mosurel N
Rangar, Ngakoutou
Siriwardana, Mahinda G
des Fontaines, Virginie Halley
Chauvin, Pierre
Pulmonary tuberculosis diagnostic delays in Chad: a multicenter, hospital-based survey in Ndjamena and Moundou
title Pulmonary tuberculosis diagnostic delays in Chad: a multicenter, hospital-based survey in Ndjamena and Moundou
title_full Pulmonary tuberculosis diagnostic delays in Chad: a multicenter, hospital-based survey in Ndjamena and Moundou
title_fullStr Pulmonary tuberculosis diagnostic delays in Chad: a multicenter, hospital-based survey in Ndjamena and Moundou
title_full_unstemmed Pulmonary tuberculosis diagnostic delays in Chad: a multicenter, hospital-based survey in Ndjamena and Moundou
title_short Pulmonary tuberculosis diagnostic delays in Chad: a multicenter, hospital-based survey in Ndjamena and Moundou
title_sort pulmonary tuberculosis diagnostic delays in chad: a multicenter, hospital-based survey in ndjamena and moundou
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519715/
https://www.ncbi.nlm.nih.gov/pubmed/22776241
http://dx.doi.org/10.1186/1471-2458-12-513
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