The article describe the knowledge, behaviors seeking health services and determine the time from onset of symptoms until the tuberculosis disease was diagnosed.
Trang 1RESEARCH ON BEHAVIORS AND DELAY IN SEEKING HEALTH
SERVICES OF TUBERCULOSIS PATIENT
AT NAM DINH PROVINCE IN 2013
Nguyen Dinh Tuan*; Nguyen Viet Nhung*; Le Van Bao**
SUMMARY
Objectives: To describe the knowledge, behaviors seeking health services and determine the time from onset of symptoms until the tuberculosis disease was diagnosed Subjects and methods: Cross-sectional study by interviewing 341 tuberculosis patients, who registered tuberculosis treatment in 4 districts of Nam Dinh province in 2013 Results: Patients lacked knowledge about tuberculosis, only 57.8% of patients correctly understood the cause of the disease, 36.1% of patients agreed to vaccinate against tuberculosis for infants and 27.6% agreed to go early examination when having signs of tuberculosis Behavior seeking health care services for the first time when tuberculosis patients with suggestive symptoms of tuberculosis
in the commune health station was 49.9% and in district general hospital was 58.7% and in private health facilities was 31.7% The time from the onset of symptoms until the diagnosed tuberculosis was fairly long, an average of 1.2 months The most common reason that patients delay in detecting tuberculosis was that they didn , t think they had tuberculosis with 74.2%, and economic difficulties accounted for 17.5% Conclusion: Patient lacked knowledge about tuberculosis, behaviors seeking health services of tuberculosis patients mainly in primary health facilities, time from onset of symptoms until tuberculosis diagnosed fairly long
* Keywords: Tuberculosis behaviors; Health services; Tuberculosis patient; Nam Dinh province
INTRODUCTION
Vietnam still has a high burden of
tuberculosis (TB), ranks 16th out of 30
countries with the highest number of
tuberculosis patients in the world and
ranks 13th out of 30 countries with a
burden of multidrug-resistant TB [1]
Nowadays, private health services have
been developing, while people seeking
health care services in private health
facilities are on the rise Several studies
have shown that private health facilities
lack of knowledge and practice about TB,
which has implications for the early detection of tuberculosis [1] Research on behavior and delays in seeking medical services of TB patients will help managers with approciated intervention plans to increase the early detection of TB
Objectives of the study:
- Describe the knowledge, behavior of seeking medical services of TB patients
- Determine the length of time from the onset of TB symptoms to the diagnosis of
TB
* Hochiminh University of Medicine and Pharmacy
**
***
Corresponding author: Nguyen Dinh Tuan (nguyendinhtuan05@gmail.com)
Date received: 08/03/2018
Date accepted: 23/05/2018
Trang 2SUBJECTS AND METHODS
1 Study subjects
Tuberculosis patients registered for
treatment in four districts of Nam Dinh
province (Xuan Truong, Giao Thuy, Truc
Ninh, Nghia Hung)
2 Methods
A cross-sectional study by interviewing
TB patients by questionnaires
* Sample size: Sample size of the
study description
Inside:
+ n: Minimum sample size
+ Z(1- /2): Reliability, with probability 95%, Z(1- /2) = 1.96
+ p: The rate of TB patients delayed in detecting ≥ 30 days; p = 0.76
+ q = 1- p = 0.24
+ d: Tolerance at 5% (d = 0.05)
Sample size was calculated (n = 281) However, the sample size in the study was all pulmonary TB patients registered treatment in 4 studying districts in 2013 The actual sample size in the study was
341 pulmonary TB patients
* Data collection: interviews of all
pulmonary TB patients by questionnaires
at the time of the study
RESULTS AND DISCUSSION
1 Characteristics of research subjects
Table 1: Characteristics of age, gender of patients (n = 341)
Age group
The average age of the TB patient was 54.0 The proportion of male was 75.1%, which was 3.0 times higher than that of female (24.9%) The age and gender of TB patients in the study matched with those of other studies and statistics 2013 of National Tuberculosis Program [4, 2]
Trang 3Table 2: Characteristics on the patient's education (n = 341)
The education level of TB patients is generally low
Table 3: Occupational characteristics of patients (n = 341)
The main occupation of TB patients is farming, accounting for 72.7%, which is suitable because the four study districts are agricultural districts
2 Knowledge and behavior of seeking medical services of TB patients
Table 4: Knowledge about the causes of tuberculosis and how to prevent it (n = 341)
Preventative measures
Trang 4Only 57.8% of the respondents were
aware of the cause of TB disease There
was a large percentage of patients with a
lack of knowledge about the cause of TB
(42.2%) The majority of patients lacked
knowledge about TB prevention, only
36.1% agreed to vaccinate newborns and
27.6% agreed to go to the clinic early
* Behavior of seeking medical services
of patients for the first time showing signs
of disease (n = 341):
Most TB patients seek health services
at the grassroots level, 58.7% chose district
general hospitals, 49.9% chose commune
health stations and 31.7% selected private
health facilities (private practitioners/clinics/
pharmacies) Patients chose provicial lung
hospital and provicial general hospital were 6.7% and 2.3%, respectively Therefore,
if there is good coordination with the grassroots level, especially with the participation of private facilities, it will help increase the proportion of people having access to TB examination services [5]
* Time delay for disease detection:
The duration from the onset of TB symptoms to TB patients diagnosed was quite long with an average of 1.2 months,
of which the detection time < 30 days accounted for 43.1% Detection time ≥ 30 days accounted for 56.9% This result is consistent with the study by Vu Ngoc Bao,
D Scott LaMontagne, Nguyen Viet Nhung [3]
Table 5: Reasons for detection delay of tuberculosis
The main reason of delayed detection
delay was that the patient did not think
they had TB with rate of 74.2% The
reason of economic difficulties accounted
for 17.5%, home far away from the district
hospital was 4.1%, troubles in the state
health facilities and didn,t know where TB
clinic was low rate (1%) This result was
consistent with studies by Vu Ngoc Bao,
D Scott LaMontagne, Nguyen Viet Nhung,
Le Thi Nga [3]
CONCLUSION
Patients lacked knowledge about tuberculosis The health service seeking behavior of the patients was mainly at the grassroots level The time from onset of symptoms until tuberculosis diagnosed was fairly long (1.2 months) The most basic reason for delaying the diagnosis was that they didn’t think they had TB (74.2%)
Trang 5RECOMMENDATION
Strengthening communication activities
and health education on TB in the
community Implementation of interventions
at the grassroots level, especially involving
private health facilities to enhance the
early detection of tuberculosis
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