Why do symptomatic patients delay obtaining care for tuberculosis ?
The resurgence of tuberculosis (TB) has coincided with deteriorating access to care for high-risk populations.
We sought to determine what perceived access barriers delayed symptomatic TB patients from obtaining care.
In order to do this, we conducted a survey in Los Angeles County, California, using a consecutive sample of patients with active TB as confirmed by the county TB control authority.
The measures used in the study were a self-reported delay in seeking care of more than 60 d from symptom onset, a period sufficient to cause skin-test conversion in exposed contacts, and self-reported access barriers.
The county TB registry provided supplementary clinical data.
We found that one in five of the 248 symptomatic respondents (response rate : 60%) delayed obtaining care for>60 d (mean=74 d, SD=216 d).
During the delay, patients exposed an average of eight contacts.
As compared with the rest of the sample, delay was more common in those who were unemployed (25% versus 14%), concerned about cost (27% versus 14%), anticipated prolonged waiting-room time (26% versus 14%), believed they could treat themselves (31% versus 14%), anticipated difficulty in getting an appointment (28% versus 16%), were uncertain about where to get care (33% versus 16%), and feared immigration authorities (47% versus 18%) (p<0.05). (...)
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Poumon, Accessibilité, Soin, Nombre, Contact, Traitement, Enquête, Cause, Délai, Homme, Poumon pathologie, Appareil respiratoire pathologie, Transmission homme homme
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Lung, Accessibility, Care, Number, Contact, Treatment, Survey, Cause, Time lag, Human, Lung disease, Respiratory disease, Transmission from man to man
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0238535
Code Inist : 002B05B02O. Création : 11/09/1998.