The care of patients with tuberculosis in Chad: a multicenter analysis in N'djamena and Moundou (2009)
TB is a major public health concern throughout the world. In the developing world, informal care is one of the factors that contribute to the spread of the epidemic through delayed treatment initiation. The objective of this study was to examine the care-seeking behavior of TB patients from the onse...
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Published in | Santé publique (Vandoeuvre-lès-Nancy, France) Vol. 24; no. Supp; pp. 55 - 66 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | French |
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01.01.2012
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Abstract | TB is a major public health concern throughout the world. In the developing world, informal care is one of the factors that contribute to the spread of the epidemic through delayed treatment initiation. The objective of this study was to examine the care-seeking behavior of TB patients from the onset of symptoms to the start of treatment and to assess the risk factors associated with the informal treatment of symptoms of tuberculosis in N'djamena and Moundou (Chad). A questionnaire survey was conducted among 286 newly diagnosed pulmonary tuberculosis patients (= 15 years old). A logistic regression model was used to assess the factors associated with informal care use. The study found that 40% of the patients had used informal care before undergoing treatment. Informal care use was found to be associated with the treatment site, belonging to a lower social class, the belief in the effectiveness of traditional treatment methods, a chronic disease and the belief that other people hide their disease. Although the diagnosis and treatment of tuberculosis are both free in Chad, delayed treatment initiation is common among many patients, who often resort to informal care. Health education, interventions aimed at reducing the financial impact of the disease and the active involvement of traditional healers in the detection of tuberculosis can contribute to promoting early access to public health services for the treatment of TB symptoms. //ABSTRACT IN FRENCH: Le recours aux soins informels contribue à l'entretien de l'épidémie de tuberculose, en retardant son diagnostic dans les pays en développement. L'objectif de cette étude est d'identifier les déterminants du type de parcours de soins menant à l'obtention du diagnostic à Ndjaména et Moundou au Tchad. La passation d'un questionnaire auprès des patients et la consultation des dossiers médicaux ont permis de recueillir les données. Les parcours thérapeutiques de 286 patients ont été analysés. Quarante pour cent des patients ont recouru à des soins informels avant de commencer le traitement antituberculeux. L'appartenance à une classe socioprofessionnelle défavorisée, la croyance en l'efficacité d'un traitement traditionnel, la conviction que les autres malades cachent leur tuberculose et la présence d'une maladie chronique ont été associés à une utilisation des soins informels au cours du parcours thérapeutique des malades. Une meilleure connaissance de la tuberculose par les populations, des mesures limitant l'impact financier de la maladie pour les patients et une implication des guérisseurs dans le dépistage de la tuberculose peuvent contribuer à une précocité de la prise en charge thérapeutique. Reproduced by permission of Bibliothèque de Sciences Po |
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AbstractList | TB is a major public health concern throughout the world. In the developing world, informal care is one of the factors that contribute to the spread of the epidemic through delayed treatment initiation. The objective of this study was to examine the care-seeking behavior of TB patients from the onset of symptoms to the start of treatment and to assess the risk factors associated with the informal treatment of symptoms of tuberculosis in N'djamena and Moundou (Chad). A questionnaire survey was conducted among 286 newly diagnosed pulmonary tuberculosis patients (= 15 years old). A logistic regression model was used to assess the factors associated with informal care use. The study found that 40% of the patients had used informal care before undergoing treatment. Informal care use was found to be associated with the treatment site, belonging to a lower social class, the belief in the effectiveness of traditional treatment methods, a chronic disease and the belief that other people hide their disease. Although the diagnosis and treatment of tuberculosis are both free in Chad, delayed treatment initiation is common among many patients, who often resort to informal care. Health education, interventions aimed at reducing the financial impact of the disease and the active involvement of traditional healers in the detection of tuberculosis can contribute to promoting early access to public health services for the treatment of TB symptoms. //ABSTRACT IN FRENCH: Le recours aux soins informels contribue à l'entretien de l'épidémie de tuberculose, en retardant son diagnostic dans les pays en développement. L'objectif de cette étude est d'identifier les déterminants du type de parcours de soins menant à l'obtention du diagnostic à Ndjaména et Moundou au Tchad. La passation d'un questionnaire auprès des patients et la consultation des dossiers médicaux ont permis de recueillir les données. Les parcours thérapeutiques de 286 patients ont été analysés. Quarante pour cent des patients ont recouru à des soins informels avant de commencer le traitement antituberculeux. L'appartenance à une classe socioprofessionnelle défavorisée, la croyance en l'efficacité d'un traitement traditionnel, la conviction que les autres malades cachent leur tuberculose et la présence d'une maladie chronique ont été associés à une utilisation des soins informels au cours du parcours thérapeutique des malades. Une meilleure connaissance de la tuberculose par les populations, des mesures limitant l'impact financier de la maladie pour les patients et une implication des guérisseurs dans le dépistage de la tuberculose peuvent contribuer à une précocité de la prise en charge thérapeutique. Reproduced by permission of Bibliothèque de Sciences Po |
Author | Ngangro, Ndeikoundam Mosurel Fontaines, Virginie Halley des Ngangro, Ndeindo Ndeikoundam Chauvin, Pierre Rangar, Ngakoutou Ngarhounoum, Doudéadoum |
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Title | The care of patients with tuberculosis in Chad: a multicenter analysis in N'djamena and Moundou (2009) |
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