Delay in tuberculosis case-finding and treatment in Mwanza, Tanzania

Bugando Medical Centre, Mwanza, Tanzania.
The International Journal of Tuberculosis and Lung Disease (Impact Factor: 2.76). 03/2000; 4(2):133-8.
Source: PubMed

ABSTRACT Health facilities in Mwanza region, Tanzania.
To determine factors responsible for delay from onset of symptoms of pulmonary tuberculosis to initiation of treatment.
A cross-sectional descriptive study of 296 smear-positive tuberculosis patients. Emphasis was given to periods between 1) onset of symptoms and first consultation to a health facility, and 2) reporting to a health facility and initiation of treatment.
Mean total delay was 185 days (median 136), with nearly 90% of this being patient's delay. The mean health system delay was 23 days (median 15), with longer delays in rural health facilities. The mean patient's delay was 162 days (median 120). This delay was significantly longer in rural areas, for patients with lower level of education, for those who first visited a traditional healer, and for patients who had no information on tuberculosis prior to diagnosis. Only 15% of the patients reported to a health facility within 30 days of onset of symptoms.
There are significant delays in case-finding in Mwanza, Tanzania, with prolonged patient's delay. Facilitation of utilisation of health services, raising awareness of the disease and incorporation of private practice into tuberculosis control could help to reduce these delays.

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    • "The overall median patient delay in this study was 30 days. This finding is lower than studies done in Ethiopia (60–63 days) [4] [22] [23] and other countries, Nepal (50 days) [24] and Tanzania (120 days) [12]. However, it is almost consistent with another study done in Ethiopia (28 days) [20]. "
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    • "Delay in diagnosis may aggravate the disease, augment the risk of death and enhance person to person transmission in the community (Odusanya and Babafemi, 2004). In Tanzania, 15% of patients were found to report to a health facility within 30 days of the onset of symptoms (Wandwalo and Morkve, 2000) while studies from Nigeria reported 81% (Enwuru et al., 2002) and 83% (Odusanya and Babafemi, 2004) patients delay for more than one month. Reasons for this are patients visiting local and poorly equipped private medical facilities, chemists, prayer houses and traditional healers; coupled with these, are poor knowledge and awareness about the disease among Africans in general (Odusanya and Babafemi, 2004; Enwuru et al., 2007; Okeibunor et al., 2007). "
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    • "volume 14 no 5 pp 564–570 may 2009 Ouedraogo et al. 2006). Most patients presented with symptoms suspicious for TB; thus, lack of diagnostic sensitivity of health workers is of concern (Wandwalo & Morkve 2000). Afghanistan has the highest TB burden in south Asia (World Health Organization 2007). "
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