Challenges TB control program; from patient's experiences

Published: 06-11-2020| Version 1 | DOI: 10.17632/7twpd239x6.1
Contributor:
Sarmin Sultana

Description

Tuberculosis is a major public health concern in Bangladesh with high morbidity and mortality rate. This mixed-method study was designed to find out the challenges faced by the TB control program at primary healthcare e settings. In this data file (Quantitative part), The TB patients were asked about their illness and treatment experiences to evaluate the gap in TB program. A total of 94 TB patients aged above 18 years were interviewed while attending the DOTS corner for a follow-up visit. A semi-structured questionnaire was designed to obtain information about the patients' socio-demographic characteristics, healthcare-seeking behavior, patient delay, health system delay and treatment delay, DOTS supervision, and health education. The question numbers (the variable name started with these question numbers in the data set) with what they represent are as below: Q1: Patient's age in completed years Q2: Initial symptoms of the patients Q4: If the patient started self-medication Q5: Patients initial visit to village doctor, local pharmacy, Imam, Priest or registered doctor and duration between initial symptom and the visit Q6: Patients visit to the registered doctor with duration between initial symptom and the visit Q7: Patients visit to any government health facility with duration between initial symptom and the visit Q8: Reason behind patient delay Q9: Diagnostic delay after visiting registered doctor Q9a: Diagnostic delay after visiting government health facility Q10: health education related questions Q11: If DOTS provider observe medicine intake Q13: DOTS provider Q 14: Treatment delay Finding: Mean patient and health system delay were 99.0 (SD = 98.7) and 42.9 (SD = 79.9) days respectively. Patient delay was related to poor care-seeking behavior, unfamiliarity with tuberculosis symptoms, and unavailability of healthcare facilities. About 74 percent of patients sought initial treatment from village doctors or drug vendors. Every second patient reported non-adherence to the directly observed treatment short-course (DOTS) guideline.

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A total of 94 TB patients aged above 18 years were interviewed while attending the DOTS corner for a follow-up visit. Data was collected through face to face interview after obtaining written informed consent. After explaining the study objectives to the respondents, interviews were conducted in isolated places of the respective health complexes. A semi-structured questionnaire was designed to obtain information about the patients' socio-demographic characteristics, healthcare-seeking behavior, patient delay, health system delay and treatment delay, DOTS supervision, and health education. Healthcare seeking behavior was evaluated by asking patients about whom they visited first with initial symptoms and the reason behind the delay in care-seeking. Patient delay was the duration from reported onset of symptoms to the first visit with a formal health provider (registered physician, e.g., MBBS or equivalent, and government or NGO healthcare staff). Health system delay was the duration between the first visit with a formal healthcare provider and diagnosis of TB, while treatment delay was the duration between confirmatory diagnosis and treatment initiation. Data were analyzed in SPSS software.