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Free Content Duration and associated factors of patient delay during tuberculosis screening in rural Cameroon

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Summary Objectives  (i) To determine patient delay – the time from the onset of symptoms to presentation at a health facility – and its causes in patients undergoing sputum smear examination in Cameroon; and (ii) to compare the results with those of a previous study in Ethiopia. Methods  A cross-sectional study of 243 consecutive patients using a structured questionnaire. Results  Median (interquartile range) patient delay in Cameroon was 2.0 (1–4) weeks, shorter than the 4.3 (2–13) week delay in Ethiopia. Significantly fewer patients delayed more than 1, 2 and 3 months in Cameroon than in Ethiopia ( < 0.001). Delays in Cameroon were significantly associated with being the main income earner, the belief that TB is stigmatizing, and the use of traditional medicine – the latter being the only factor significant in both studies. Conclusion  Engaging traditional healers in TB control programs and reducing stigma through education could help to reduce patient delays, accelerate diagnosis, improve clinical outcomes and reduce disease transmission. These results, when placed in context of national human development indices, suggest that economic development, investment in health care and literacy may all be involved in improving access to TB services in sub-Saharan Africa.

French
Durée et facteurs associés pour le retard du patient durant le criblage pour la tuberculose en zone rurale au Cameroun Objectifs: 

(1) Déterminer le retard du patient - temps du début des symptômes à la présentation dans un service de santé - et ses causes chez les patients subissant un examen de frottis de crachat au Cameroun et (2) Comparer les résultats à ceux d’une étude précédente en Ethiopie. Méthodes: 

Étude transversale sur 243 patients consécutifs employant un questionnaire structuré. Résultats: 

Le retard médian du patient au Cameroun était de 2,0 semaines (intervalle interquartile: 1-4), plus court que le retard de 4,3 semaine (2-13) en Ethiopie. Significativement moins de patients ont accusé du retard de plus de 1, 2 et 3 mois au Cameroun qu’en Ethiopie (p < 0,001). Les retards au Cameroun étaient significativement associés au fait d’être l’acquéreur principal de revenu, la croyance que la TB est stigmatisante et l’utilisation de la médecine traditionnelle, ce dernier étant le seul facteur significatif dans les deux études. Conclusion: 

L’implication des guérisseurs traditionnels dans des programmes de contrôle de la TB et la réduction du stigmat par l’éducation pourraient aider à réduire le retard du patient, accélérer le diagnostic, améliorer des résultats cliniques et réduire la transmission de la maladie.
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Keywords: Cameroon; Cameroun; Camerún; Ethiopia; Ethiopie; Etiopía; medicina tradicional; médecine traditionnelle; patient delay; retard du patient; retraso paciente; traditional medicine; tuberculose; tuberculosis

Document Type: Research Article

Affiliations: 1:  St. Elizabeth General Hospital, Shisong, Cameroon 2:  Liverpool School of Tropical Medicine, Liverpool, UK

Publication date: 01 November 2007

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