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. 2012;7(8):e42458.
doi: 10.1371/journal.pone.0042458. Epub 2012 Aug 6.

How did the TB patients reach DOTS services in Delhi? A study of patient treatment seeking behavior

Sunil K Kapoor  1 , A Venkat Raman, Kuldeep Singh Sachdeva, Srinath Satyanarayana
Affiliations

How did the TB patients reach DOTS services in Delhi? A study of patient treatment seeking behavior

Sunil K Kapoor et al. PLoS One. 2012.

Abstract

Setting: Revised National Tuberculosis Control Programme (RNTCP), Delhi, India.

Objective: To ascertain the number and sequence of providers visited by TB patients before availing treatment services from DOTS; to describe the duration between onset of symptoms to treatment.

Study design: A cross sectional, qualitative study. Information was gathered through in-depth interviews of TB patients registered during the month of Oct, 2012 for availing TB treatment under the Revised National TB Control Programme from four tuberculosis diagnosis and treatment centers in Delhi.

Results: Out of the 114 patients who registered, 108 participated in the study. The study showed that informal providers and retail chemists were the first point of contact and source of clinical advice for two-third of the patients, while the rest sought medical care from qualified providers directly. Most patients sought medical care from more than two providers, before being diagnosed as TB. Female TB patients and patients with extra-pulmonary TB had long mean duration between onset of symptoms to initiation of treatment (6.3 months and 8.4 months respectively).

Conclusion: The pathways followed by TB patients, illustrated in this study, provide valuable lessons on the importance of different types of providers (both formal and informal) in the health system in a society like India and the delays in the diagnosis and treatment of tuberculosis.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Pathways undertaken by the patients to reach the RNTCP (DOTS) Facilities, Delhi, India.
Figure 2
Figure 2. Pathway taken by patients to reach health facilities with RNTCP (DOTS) services in relation to the type of health care provider and frequency of consultation.
See this image and copyright information in PMC

References

    1. World Health Organisation, Geneva (2012) Global tuberculosis control 2011. Available: http://www.who.int/tb/publications/global_report/en/index.html. Accessed on 2012 May 12..
    1. Stop TB Department (2011) The Global Plan to Stop TB 2011–2015, World Health Organisation, Geneva. Available: http://www.stoptb.org/global/plan/. Accessed on 2012 May 12..
    1. Sreeramareddy CT, Panduru KV, Menten J, Van den Ende J (2009) Time delays in diagnosis of pulmonary tuberculosis: a systematic review of literature. BMC Infect Dis 9: 91. 1471-2334-9-91 [pii];10.1186/1471-2334-9-91 [doi]. - DOI - PMC - PubMed
    1. Central Tuberculosis Division (2011) Tuberculosis India 2011, Annual report of the Revised National Tuberculosis Control Programme, Ministry of Health and Family Welfare, Government of India. Available: http://www.tbcindia.nic.in/pdfs/RNTCP%20TB%20India%202011.pdf. Accessed on 2012 May 19..
    1. Uplekar MW (2003) Public-private mix for DOTS: demanding, but delay will only hamper TB control. Int J Tuberc Lung Dis 7: 1113–1114. - PubMed