Health care seeking behavior of cough symptomatics (Pulmonary Tuberculosis Suspects) attending medicine outpatient department of a tertiary care hospital of Jharkhand

Abstract

Delay in diagnosis of Pulmonary tuberculosis results in increase its infectivity in the community which contributes to adverse sequelae and overall mortality. This study assessed socio demographic determinants of patient delay and main reasons behind these delays. It also attempted to find out type of first health care personnels (HCPs) and its association with socio demographic variables. It was a cross sectional, descriptive and hospital based study. Total duration of study was 15 months (March 2013-May 2014), conducted in Medicine Outpatient department (OPD) of RIMS, Ranchi. A total of 656 cough symptomatics were selected as study subjects and interviewed by using pre tested, semi structured questionnaire after getting their written consent. Significant association was established by the use of Chi square test( p<0.05). It was found that majority(75.61%) of the patients were having significant patient delay(>30 days).Main reasons for delay were self medication(202,30.79%)and perception of symptom will disappear/not severe(87,13.26%).Over half of the patients(343,52.29%) consulted Government health care personnel(HCPs),unqualified practitioners were main care givers in (159,24.24%)patients followed by qualified private practitioners(154,23.47%).Demographic variables such as Poverty, illiteracy, rural background and advanced age group were strongly associated with patient delay and seeking care from unqualified practitioners. It was concluded that effective IEC services should be widely disseminated to the community so that early symptoms of tuberculosis can be recognized and treatment can be started as soon as possible.