Health care seeking among pulmonary tuberculosis suspects and patients in rural Ethiopia: a community-based study

Yimer, Solomon; Holm-Hansen, Carol; Yimaldu, Tilahun; Bjune, Gunnar
January 2009
BMC Public Health;2009, Vol. 9 Issue 1, p454
Academic Journal
Background: Health care seeking is a dynamic process that is influenced by socio-demographic, cultural and other factors. In Ethiopia, there are limited studies regarding the health seeking behaviour of tuberculosis (TB) suspects and TB patients. However, a thorough understanding of patients' motivation and actions is crucial to understanding TB and the treatment of disease. Such insights would conceivably help to reduce delay in diagnosis, improve treatment adherence and thereby reduce transmission of TB in the community. The objective of this study was to describe and analyze health care seeking among TB suspects and pulmonary TB (PTB) cases in a rural district of the Amhara Region in Ethiopia. Methods: Study kebeles were randomly selected in a cross-sectional study design. House-to-house visits were conducted in which individuals aged 15 years and above in all households of the kebeles were included. Subjects with symptoms suggestive of TB were interviewed about their health seeking behaviour, socio-demographic and clinical factors using a semi-structured questionnaire. Logistics regression analysis was employed to assess associations between the independent and outcome variables. Results: The majority, 787 (78%), TB suspects and 33 (82.5%) PTB cases had taken health care actions for symptoms from sources outside their homes. The median delay before the first action was 30 days. In logistics regression, women (AOR 0.8, 95% CI 0.6, 0.9) were found to be less likely to visit a medical health provider than men. Those with a long duration of cough (AOR 1.5, 95% CI 1.03, 2.1) and those with a previous history of TB (AOR 1.5, 95% CI 1.03, 2.3) were more likely to visit a medical health provider compared to those with a shorter duration of cough and with no history of TB. Conclusion: The majority of TB suspects and PTB cases had already taken health care actions for their symptoms at the time of the survey. The availability of a simple and rapid diagnostic TB test for use at the lowest level of health care and the involvement of all health providers in case finding activities are imperative for early TB case detection.


Related Articles

  • Natural Ventilation for the Prevention of Airborne Contagion. Escombe, A. Roderick; Oeser, Clarissa C.; Gilman, Robert H.; Navincopa, Marcos; Ticona, Eduardo; Pan, William; Martínez, Carlos; Chacaltana, Jesus; Rodríguez, Richard; Moore, David A. J.; Friedland, Jon S.; Evans, Carlton A. // PLoS Medicine;Feb2007, Vol. 4 Issue 2, p309 

    Background Institutional transmission of airborne infections such as tuberculosis (TB) is an important public health problem, especially in resource-limited settings where protective measures such as negative-pressure isolation rooms are difficult to implement. Natural ventilation may offer a...

  • Investigación sobre epidemiología convencional y molecular de tuberculosis en Orizaba, Veracruz, 1995-2008. Jiménez-Corona, Ma Eugenia; Garcêa-Garcêa, Lourdes; de León, Alfredo Ponce; Bobadilla-del Valle, Miriam; Torres, Martha; Canizales-Quintero, Sergio; Palacios-Merino, Carmen; Molina-Hernández, Susana; Martênez-Gamboa, Rosa Areli; Juárez-Sandino, Luis; Cano-Arellano, Bulmaro; Ferreyra-Reyes, Leticia; Cruz-Hervert, Luis Pablo; Báez-Saldaña, Renata; Ferreira-Guerrero, Elizabeth; Sada, Eduardo; Marquina, Brenda; Sifuentes-Osornio, José // Salud Pública de México;mar/abr2009 Supplement, Vol. 51 Issue S3, pS470 

    This study describes the achievements of the Mexican Consortium against Tuberculosis, in the Sanitary District of Orizaba, Veracruz, Mexico between 1995 and 2008. In brief, the main results can be classified as follows: 1) Conventional and molecular epidemiology (measurement of burden of...

  • The Transmission Dynamics of Tuberculosis in a Recently Developed Chinese City. Peng Wu; Lau, Eric H. Y.; Cowling, Benjamin J.; Chi-Chiu Leung; Cheuk-Ming Tam; Leung, Gabriel M. // PLoS ONE;2010, Vol. 5 Issue 5, p1 

    Background: Hong Kong is an affluent subtropical city with a well-developed healthcare infrastructure but an intermediate TB burden. Declines in notification rates through the 1960s and 1970s have slowed since the 1980s to the current level of around 82 cases per 100 000 population. We studied...

  • Letter. Delay in diagnosis of tuberculosis: of remaining concern in England and Wales. Wares, D. F.; Ormerod, L. P.; Morton, S. // Journal of Public Health Medicine;Sep1999, Vol. 21 Issue 3, p355 

    The article presents a discussion on the issues related to the delay in diagnosis of tuberculosis in effected people in England and Wales. These delays are reportedly common and the author considers that it has an impact at both the individual level and community level by increasing the risks of...

  • Eras, Paradigms, and the Future of Epidemiology. Winkelstein Jr., Warren // American Journal of Public Health;May96, Vol. 86 Issue 5, p621 

    The author offers observation on epidemiology and its role in public health and society. He describes the first textbook of epidemiology, "Epidemics and Crowd-Diseases: An Introduction to the Study of Epidemiology," by Major Greenwood. He analyzes the article "Choosing a Future for Epidemiology:...

  • Public health management of mass gatherings: the Saudi Arabian experience with MERS-CoV. Memish, Ziad A.; Al-Rabeeah, Abdullah A. // Bulletin of the World Health Organization;Dec2013, Vol. 91 Issue 12, p899 

    The authors reflect on the public health challenges associated with mass gatherings, including the Saudi Arabian pilgrimage or hajj, and on an outbreak of Middle East respiratory syndrome coronavirus which was seen in 2013 in Saudi Arabia. They suggest that health challenges posed by mass...

  • Epidemiology should not be underrated. Stone, David // GP: General Practitioner;5/5/2003, p76 

    Epidemiology is often regarded purely as a research tool,but that is too narrow a view. The practical, non-research uses of epidemiology in general practice are numerous. They may be summarised by the mnemonic PIE, planning, implementation, evaluation. The planning process is similar in each and...

  • International Research: The People's Republic of China. Wegman, Myron E. // American Journal of Public Health;Jan1980, Vol. 70 Issue 1, p9 

    Comparative studies of health conditions and medical problems involving various nations and cultures may cast light on a frequently complex and difficult scientific problem and at the same time, have highly practical significance for the populations involved. Examples include large scale...

  • Studying Optimal Healing Environments: Challenges and Proposals. O'Malley, Patrick G. // Journal of Alternative & Complementary Medicine;Dec2005 Supplement 1, Vol. 11, ps-17 

    The concept of optimal healing environments has strong face validity, but it is difficult to operationalize the complexity of the human dimensions that comprise the process of healing. Only rigorous evidence can justify the tremendous resources necessary to create optimal healing environments....


Read the Article


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

Try another library?
Sign out of this library

Other Topics