Health seeking behaviour, health system experience and tuberculosis case finding in Gambians with cough

Kasse, Yaya; Jasseh, Momodou; Corrah, Tumani; Donkor, Simon A.; Antonnio, Martin; Jallow, Adama; Adegbola, Richard A.; Hill, Philip C.
January 2006
BMC Public Health;2006, Vol. 6 Issue 1, p143
Academic Journal
Background: Studies in Africa investigating health-seeking behaviour by interviewing tuberculosis patients have revealed patient knowledge issues and significant delays to diagnosis. We aimed to study health-seeking behaviour and experience of those with cough in The Gambia and to identify whether they had tuberculosis. Methods: During a round of a population under 3-monthly demographic surveillance, we identified people >10 years old who had been coughing ≥ 3 weeks. A questionnaire was administered concerning demographic data, cough, knowledge, health seeking, and experience at health facilities. Case finding utilised sputum smear and chest X-ray. Results: 122/29,871 coughing individuals were identified. Of 115 interviewed, 93 (81%) had sought treatment; 76 (81.7%) from the health system. Those that visited an alternative health provider first were significantly older than those who visited the health system first (p = 0.03). The median time to seek treatment was 2 weeks (range 0 - 106). 54 (58.1%) made their choice of provider because they believed it was right. Of those who left the health system to an alternative provider (n = 13): 7 believed it was the best place, 3 cited cost and 2 failure to improve. 3 cases were identified by sputum analysis, 11 more by X-ray; all had visited the health system first. Total 'excess' cough time was 1079 person weeks. Conclusion: The majority of people with cough in this population seek appropriate help early. Improved case detection might be achieved through the use of chest X-ray in addition to sputum smear.


Related Articles

  • Quality of tuberculosis care and its association with patient adherence to treatment in eight Ethiopian districts. Mesfin, Mengiste M.; Newell, James N.; Walley, John D.; Gessessew, Amanuel; Tesfaye, Tassew; Lemma, Frew; Madeley, Richard J. // Health Policy & Planning;Nov2009, Vol. 24 Issue 6, p457 

    Background Little is known about the quality of tuberculosis (TB) service delivery in public health facilities in Ethiopia and its association with patients’ non-adherence to TB treatment. This study assessed the organization, management and processes of TB care delivery, and their...

  • A framework for assessing the performance of health systems. Murray, Christopher J.L.; Frenk, Julio // Bulletin of the World Health Organization;2000, Vol. 78 Issue 6, p717 

    Proposes ways of improving the performance of health systems. Factors influencing health system performance; Boundaries of health systems based on health action concept; Fundamental goal of health system performance; Ways of improving health; Understanding of health system performance through...

  • Master class. Cassil, Alwyn // AHA News;06/23/97, Vol. 33 Issue 24, p5 

    Reports on health systems' active participation in promoting community awareness in the United States. Allina Health System's efforts in passing a tough youth-access-to-tobacco bill; Vision of improving community health; Hostility and skepticism of the public towards the move; Forging community...

  • Accession to the European Union—an opportunity and a challenge for health systems and public health. Albreht, Tit // European Journal of Public Health;Jun2014, Vol. 24 Issue 3, p353 

    The article discusses the important opportunities and challenges of the accession to the European Union (EU) for several European countries in terms of health systems and public health. It reveals that the 2004 EU accession has improved comparative work and benchmarking and provided assistance...

  • Healthier communities and the business of creating health. Coye, Molly Joel // Healthcare Executive;Jul/Aug1995, Vol. 10 Issue 4, p4 

    Suggests that aligning business purposes of health systems with community health is a key to success for hospital-based health systems. Role hospital-based providers play in efforts to improve American community health; New forces in healthcare delivery; Positive changes at the Good Samaritan...

  • The Centre for Tuberculosis: from reference laboratory to public health institution. Ismail, Nazir; Ihekweazu, Chikwe; Koornhof, Hendrik; Madhi, Shabir // Southern African Journal of Epidemiology & Infection;2012, Vol. 27 Issue 3, p91 

    The article presents information on the Centre for Tuberculosis (CTB) of the National Institute for Communicable Diseases (NICD) of South Africa. It highlights that the CTB's role include management of tuberculosis patients and evaluation of novel methods. It points out that the CTB will be...

  • Socioeconomic impact of TB on patients registered within RNTCP and their families in the year 2007 in Chennai, India. Ananthakrishnan, Ramya; Jeyaraj, Anita; Palani, Gopal; Sathiyasekaran, B. W. C. // Lung India;Jul-Sep2012, Vol. 29 Issue 3, p221 

    Background: Tuberculosis patients are registered in government clinics under Directly Observed Treatment Short-course (DOTS) program in Chennai city catering to 4.34 million population. With the entire country geographically covered under the DOTS program, research into socioeconomic impact of...

  • Accuracy of Probabilistic Linkage Using the Enhanced Matching System for Public Health and Epidemiological Studies. Aldridge, Robert W.; Shaji, Kunju; Hayward, Andrew C.; Abubakar, Ibrahim // PLoS ONE;8/24/2015, Vol. 10 Issue 8, p1 

    Background: The Enhanced Matching System (EMS) is a probabilistic record linkage program developed by the tuberculosis section at Public Health England to match data for individuals across two datasets. This paper outlines how EMS works and investigates its accuracy for linkage across public...

  • Surveillance of Tuberculosis in Taipei: The Influence of Nontuberculous Mycobacteria. Chiang, Chen-Yuan; Yu, Ming-Chih; Yang, Shiang-Lin; Yen, Muh-Yong; Bai, Kuan-Jen // PLoS ONE;11/6/2015, Vol. 10 Issue 10, p1 

    Background: Notification of tuberculosis (TB) but not nontuberculous mycobacteria (NTM) is mandatory in Taiwan. Partly due to the strict regulation on TB notification, several patients infected with NTM were notified as TB cases. Notification of patients infected with NTM as TB cases can...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics