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Why and where?—Delay in Tuberculosis care cascade: A cross-sectional assessment in two Indian states, Jharkhand, Gujarat

Tuberculosis (TB) is the second leading cause of death due to infectious diseases globally, and delay in the TB care cascade is reported as one of the major challenges in achieving the goals of the TB control programs. The main aim of this study was to investigate the delay and responsible factors f...

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Autores principales: Yasobant, Sandul, Shah, Harsh, Bhavsar, Priya, Patel, Jay, Saha, Somen, Sinha, Anish, Puwar, Tapasvi, Patel, Yogesh, Saxena, Deepak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9911525/
https://www.ncbi.nlm.nih.gov/pubmed/36778538
http://dx.doi.org/10.3389/fpubh.2023.1015024
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author Yasobant, Sandul
Shah, Harsh
Bhavsar, Priya
Patel, Jay
Saha, Somen
Sinha, Anish
Puwar, Tapasvi
Patel, Yogesh
Saxena, Deepak
author_facet Yasobant, Sandul
Shah, Harsh
Bhavsar, Priya
Patel, Jay
Saha, Somen
Sinha, Anish
Puwar, Tapasvi
Patel, Yogesh
Saxena, Deepak
author_sort Yasobant, Sandul
collection PubMed
description Tuberculosis (TB) is the second leading cause of death due to infectious diseases globally, and delay in the TB care cascade is reported as one of the major challenges in achieving the goals of the TB control programs. The main aim of this study was to investigate the delay and responsible factors for the delay in the various phases of care cascade among TB patients in two Indian states, Jharkhand and Gujarat. This cross-sectional study was conducted among 990 TB patients from the selected tuberculosis units (TUs) of two states. This study adopted a mixed-method approach for the data collection. The study targeted a diverse profile of TB patients, such as drug-sensitive TB (DSTB), drug resistance TB (DRTB), pediatric TB, and extra-pulmonary TB. It included both public and private sector patients. The study findings suggested that about 41% of pulmonary and 51% of extra-pulmonary patients reported total delay. Delay in initial formal consultation is most common, followed by a delay in diagnosis and treatment initiation in pulmonary patients. While in extra-pulmonary patients, delay in treatment initiation is most common, followed by the diagnosis and first formal consultation. DR-TB patients are more prone to total delay and delay in the treatment initiation among pulmonary patients. Addiction, co-morbidity and awareness regarding monetary benefits available for TB patients contribute significantly to the total delay among pulmonary TB patients. There were system-side factors like inadequacy in active case findings, poor infrastructure, improper adverse drug reaction management and follow-up, resulting in delays in the TB care cascade in different phases. Thus, the multi-disciplinary strategies covering the gambit of both system and demand side attributes are recommended to minimize the delays in the TB care cascade.
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spelling pubmed-99115252023-02-11 Why and where?—Delay in Tuberculosis care cascade: A cross-sectional assessment in two Indian states, Jharkhand, Gujarat Yasobant, Sandul Shah, Harsh Bhavsar, Priya Patel, Jay Saha, Somen Sinha, Anish Puwar, Tapasvi Patel, Yogesh Saxena, Deepak Front Public Health Public Health Tuberculosis (TB) is the second leading cause of death due to infectious diseases globally, and delay in the TB care cascade is reported as one of the major challenges in achieving the goals of the TB control programs. The main aim of this study was to investigate the delay and responsible factors for the delay in the various phases of care cascade among TB patients in two Indian states, Jharkhand and Gujarat. This cross-sectional study was conducted among 990 TB patients from the selected tuberculosis units (TUs) of two states. This study adopted a mixed-method approach for the data collection. The study targeted a diverse profile of TB patients, such as drug-sensitive TB (DSTB), drug resistance TB (DRTB), pediatric TB, and extra-pulmonary TB. It included both public and private sector patients. The study findings suggested that about 41% of pulmonary and 51% of extra-pulmonary patients reported total delay. Delay in initial formal consultation is most common, followed by a delay in diagnosis and treatment initiation in pulmonary patients. While in extra-pulmonary patients, delay in treatment initiation is most common, followed by the diagnosis and first formal consultation. DR-TB patients are more prone to total delay and delay in the treatment initiation among pulmonary patients. Addiction, co-morbidity and awareness regarding monetary benefits available for TB patients contribute significantly to the total delay among pulmonary TB patients. There were system-side factors like inadequacy in active case findings, poor infrastructure, improper adverse drug reaction management and follow-up, resulting in delays in the TB care cascade in different phases. Thus, the multi-disciplinary strategies covering the gambit of both system and demand side attributes are recommended to minimize the delays in the TB care cascade. Frontiers Media S.A. 2023-01-27 /pmc/articles/PMC9911525/ /pubmed/36778538 http://dx.doi.org/10.3389/fpubh.2023.1015024 Text en Copyright © 2023 Yasobant, Shah, Bhavsar, Patel, Saha, Sinha, Puwar, Patel and Saxena. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Yasobant, Sandul
Shah, Harsh
Bhavsar, Priya
Patel, Jay
Saha, Somen
Sinha, Anish
Puwar, Tapasvi
Patel, Yogesh
Saxena, Deepak
Why and where?—Delay in Tuberculosis care cascade: A cross-sectional assessment in two Indian states, Jharkhand, Gujarat
title Why and where?—Delay in Tuberculosis care cascade: A cross-sectional assessment in two Indian states, Jharkhand, Gujarat
title_full Why and where?—Delay in Tuberculosis care cascade: A cross-sectional assessment in two Indian states, Jharkhand, Gujarat
title_fullStr Why and where?—Delay in Tuberculosis care cascade: A cross-sectional assessment in two Indian states, Jharkhand, Gujarat
title_full_unstemmed Why and where?—Delay in Tuberculosis care cascade: A cross-sectional assessment in two Indian states, Jharkhand, Gujarat
title_short Why and where?—Delay in Tuberculosis care cascade: A cross-sectional assessment in two Indian states, Jharkhand, Gujarat
title_sort why and where?—delay in tuberculosis care cascade: a cross-sectional assessment in two indian states, jharkhand, gujarat
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9911525/
https://www.ncbi.nlm.nih.gov/pubmed/36778538
http://dx.doi.org/10.3389/fpubh.2023.1015024
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