Title:
Treatment Delays Among Smear-Positive Pulmonary Tuberculosis Patients in Sudan : A Comparative Analysis Between One Rural and One Urban Setting in Sudan
Authors:
Fadul, Selma Ahmed A.
Year:
2013
PAGE:
xii, 62
Language:
En
Subject:
mHealth in Low-Resource Settings
Keywords:
Tuberculosis, TB, Sudan, Smear-Positive, Delays, Rural, Urban
Abstract:
Background: Delay in TB diagnosis and treatment exacerbates its morbidity, mortality and increases transmission of the disease within the community. General Objective: The main objective of this study is to perform a comparative analysis of two national studies addressing delays in diagnosis and treatment of new smear-positive pulmonary tuberculosis in two different contexts (urban and rural) and review the findings against current published evidence in order to provide evidence-based recommendations to Sudan NTP towards improving national TB prevention and care activities. Methodology: The methodology applied was descriptive and comparative analysis of two national studies against current published evidence. Results: The main factors significantly associated with longer pre-treatment period at rural setting were divorced/widow, higher income, and use of traditional self-medication before reaching any health provider. Factors significantly associated with longer patient’s period at rural setting were middle age, lower educational level, prolonged walking distance to the TBMU and lower sputum grading for AFB. Factors significantly associated with longer health system’s period at rural setting were female, divorced/widow, higher level of education, higher monthly income, large family size, and failure to suspect TB as explained by not requesting X-ray examination. Conclusions and Recommendations Generally, all the three periods were longer at rural than urban setting. Despite having some significant socioeconomic factors contributing to prolonged patient’s period, nevertheless, the contribution of the same socioeconomic factors in addition to other factors have contributed to a lower suspicion index among the health providers which was reflected in the significantly longer health system’s period at rural setting. Despite the clear guidance by the National TB control Programme (NTP) on the importance of performing sputum examination to all patients presenting with cough for more than two weeks, most of the health providers still consider some other factors before applying the TB management guidelines. Sudan NTP is highly recommended to disseminate and enforce the application of the national TB management guidelines among all health providers. Other recommendations to the NTP include enhancing the public health education on TB and interdisciplinary approach to tackle socioeconomic barriers to TB healthcare.
Organization:
KIT - Royal Tropical Institute
,
VU - Vrije Universiteit Amsterdam
Institute:
KIT (Royal Tropical Institute)
Department:
Development, Policy and Practice
Country:
Sudan
Region:
Northeastern Africa
Training:
Master of Public Health / International Course in Health Development (MPH/ICHD)
Category:
Research
Right:
© 2013 Fadul
Document type:
Thesis/dissertation
File:
H2puDaZbk9_20161024151248276.pdf