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Rural poverty and delayed presentation to tuberculosis services in Ethiopia
Author(s) -
Cambanis Alexis,
Yassin Mohammed A.,
Ramsay Andy,
Bertel Squire S.,
Arbide Isabel,
Cuevas Luis E.
Publication year - 2005
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2005.01393.x
Subject(s) - tuberculosis , medicine , poverty , residence , rural area , presentation (obstetrics) , developing country , health facility , sputum , health services , family medicine , environmental health , surgery , population , demography , economic growth , pathology , sociology , economics
Summary To measure time to initial presentation and assess factors influencing the decision to seek medical attention, we interviewed 243 patients undergoing sputum examination for the diagnosis of tuberculosis (TB) at a rural health centre near Awassa, Ethiopia. A structured questionnaire was used. Median (mean + SD) patient delay was 4.3 (9.8 + 12.4) weeks. Delays over 4 weeks were significantly associated with rural residence, transport time over 2 h, overnight travel, transport cost exceeding US$1.40, having sold personal assets prior to the visit, and use of traditional medicine. The majority of patients cited economic or logistical barriers to health care when asked directly about causes of delay. Case‐finding strategies for TB must be sensitive to patient delay and health systems must become more accessible in rural areas.