Understanding health care-seeking behaviour of the tribal population in India among those with presumptive TB symptoms.
<h4>Background and objectives</h4>Understanding the drivers for care-seeking among those who present with symptoms of TB is crucial for early diagnosis of TB and prompt treatment, which will in turn halt further TB transmission. While TB is a challenge among the tribal population, little...
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oai:doaj.org-article:89d9556f63e9412788aeee9c90bdf8db2021-12-02T20:04:00ZUnderstanding health care-seeking behaviour of the tribal population in India among those with presumptive TB symptoms.1932-620310.1371/journal.pone.0250971https://doaj.org/article/89d9556f63e9412788aeee9c90bdf8db2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0250971https://doaj.org/toc/1932-6203<h4>Background and objectives</h4>Understanding the drivers for care-seeking among those who present with symptoms of TB is crucial for early diagnosis of TB and prompt treatment, which will in turn halt further TB transmission. While TB is a challenge among the tribal population, little is known about the care-seeking behaviour and the factors influencing care-seeking behaviour among the tribal population across India.<h4>Methodology</h4>This community-based descriptive study was carried out in 17 states of India across 6 zones, covering 88 villages from tribal districts with over 70% tribal population. The sample population included individuals ≥15 years old who were screened through an interview for symptoms suggestive of pulmonary TB (PTB), currently and/or previously on anti-TB treatment. Those with symptoms were then assessed on their health-seeking behavior using a semi-structured interview schedule.<h4>Results</h4>Among 74532 eligible participants screened for symptoms suggestive of TB, 2675 (3.6%) were found to be presumptive TB cases. Of them, 659 (24.6%) sought care for their symptoms. While 48.2% sought care after a week, 19.3% sought care after one month or more, with no significant difference in the first point of care; 46.9% approaching a private and 46.7% a public facility. The significant factors influencing care-seeking behaviour were knowledge on TB (OR: 4.64 (3.70-5.83), p < 0.001), age<35 years (OR: 1.60 (1.28-2.00), p < 0.001), co-morbidities like asthma (OR: 1.80 (1.38-2.35), p < 0.001) and blood pressure (OR: 2.59 (1.75-3.85), p < 0.001), symptoms such as blood in sputum (OR: 1.69 (1.32-2.16), p < 0.001), shortness of breath (OR: 1.43 (1.19-1.72), p < 0.001) and weight loss (OR: 1.59 (1.33-1.89), p < 0.001). The cough was the most often reported symptom overall. There were gender differences in symptoms that prompted care-seeking: Males were more likely to seek care for weight loss (OR: 1.78 (1.42-2.23), p<0.001), blood in the sputum (OR: 1.69 (1.25-2.28), p<0.001), shortness of breath (OR: 1.49 (1.18-1.88), p<0.001) and fever (OR: 1.32 (1.05-1.65), p = 0.018). Females were more likely to seek care for blood in sputum (OR: 1.68 (1.10-2.58), p = 0.018) and shortness of breath (OR = 1.35, (1.01-1.82), p = 0.048). The cough did not feature as a significant symptom that prompted care-seeking.<h4>Conclusion</h4>Delayed healthcare-seeking behaviour among those with symptoms presumptive of TB in the tribal population is a major concern. Findings point to differences across gender about symptoms that prompt care-seeking in this population. Gender-sensitive interventions with health system strengthening are urgently needed to facilitate early diagnosis and treatment among this population.Beena E ThomasKannan ThiruvengadamRaghavi SSudha RaniVetrivel SVikas Gangadhar RaoRajiv YadavBhat JVijayachari PaluruAnil Jacob PurthyTahziba HussainAnil Kumar Indira KrishnaAlex JosephAvi Kumar BansalPraveen AnandPradeep DasK R JohnRekha Devi KSunish PRony MoralAzhagendran SChandrasekaran VToteja G SMadhuchhanda DasA M KhanHarpreet KaurPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0250971 (2021) |
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Medicine R Science Q |
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Medicine R Science Q Beena E Thomas Kannan Thiruvengadam Raghavi S Sudha Rani Vetrivel S Vikas Gangadhar Rao Rajiv Yadav Bhat J Vijayachari Paluru Anil Jacob Purthy Tahziba Hussain Anil Kumar Indira Krishna Alex Joseph Avi Kumar Bansal Praveen Anand Pradeep Das K R John Rekha Devi K Sunish P Rony Moral Azhagendran S Chandrasekaran V Toteja G S Madhuchhanda Das A M Khan Harpreet Kaur Understanding health care-seeking behaviour of the tribal population in India among those with presumptive TB symptoms. |
| description |
<h4>Background and objectives</h4>Understanding the drivers for care-seeking among those who present with symptoms of TB is crucial for early diagnosis of TB and prompt treatment, which will in turn halt further TB transmission. While TB is a challenge among the tribal population, little is known about the care-seeking behaviour and the factors influencing care-seeking behaviour among the tribal population across India.<h4>Methodology</h4>This community-based descriptive study was carried out in 17 states of India across 6 zones, covering 88 villages from tribal districts with over 70% tribal population. The sample population included individuals ≥15 years old who were screened through an interview for symptoms suggestive of pulmonary TB (PTB), currently and/or previously on anti-TB treatment. Those with symptoms were then assessed on their health-seeking behavior using a semi-structured interview schedule.<h4>Results</h4>Among 74532 eligible participants screened for symptoms suggestive of TB, 2675 (3.6%) were found to be presumptive TB cases. Of them, 659 (24.6%) sought care for their symptoms. While 48.2% sought care after a week, 19.3% sought care after one month or more, with no significant difference in the first point of care; 46.9% approaching a private and 46.7% a public facility. The significant factors influencing care-seeking behaviour were knowledge on TB (OR: 4.64 (3.70-5.83), p < 0.001), age<35 years (OR: 1.60 (1.28-2.00), p < 0.001), co-morbidities like asthma (OR: 1.80 (1.38-2.35), p < 0.001) and blood pressure (OR: 2.59 (1.75-3.85), p < 0.001), symptoms such as blood in sputum (OR: 1.69 (1.32-2.16), p < 0.001), shortness of breath (OR: 1.43 (1.19-1.72), p < 0.001) and weight loss (OR: 1.59 (1.33-1.89), p < 0.001). The cough was the most often reported symptom overall. There were gender differences in symptoms that prompted care-seeking: Males were more likely to seek care for weight loss (OR: 1.78 (1.42-2.23), p<0.001), blood in the sputum (OR: 1.69 (1.25-2.28), p<0.001), shortness of breath (OR: 1.49 (1.18-1.88), p<0.001) and fever (OR: 1.32 (1.05-1.65), p = 0.018). Females were more likely to seek care for blood in sputum (OR: 1.68 (1.10-2.58), p = 0.018) and shortness of breath (OR = 1.35, (1.01-1.82), p = 0.048). The cough did not feature as a significant symptom that prompted care-seeking.<h4>Conclusion</h4>Delayed healthcare-seeking behaviour among those with symptoms presumptive of TB in the tribal population is a major concern. Findings point to differences across gender about symptoms that prompt care-seeking in this population. Gender-sensitive interventions with health system strengthening are urgently needed to facilitate early diagnosis and treatment among this population. |
| format |
article |
| author |
Beena E Thomas Kannan Thiruvengadam Raghavi S Sudha Rani Vetrivel S Vikas Gangadhar Rao Rajiv Yadav Bhat J Vijayachari Paluru Anil Jacob Purthy Tahziba Hussain Anil Kumar Indira Krishna Alex Joseph Avi Kumar Bansal Praveen Anand Pradeep Das K R John Rekha Devi K Sunish P Rony Moral Azhagendran S Chandrasekaran V Toteja G S Madhuchhanda Das A M Khan Harpreet Kaur |
| author_facet |
Beena E Thomas Kannan Thiruvengadam Raghavi S Sudha Rani Vetrivel S Vikas Gangadhar Rao Rajiv Yadav Bhat J Vijayachari Paluru Anil Jacob Purthy Tahziba Hussain Anil Kumar Indira Krishna Alex Joseph Avi Kumar Bansal Praveen Anand Pradeep Das K R John Rekha Devi K Sunish P Rony Moral Azhagendran S Chandrasekaran V Toteja G S Madhuchhanda Das A M Khan Harpreet Kaur |
| author_sort |
Beena E Thomas |
| title |
Understanding health care-seeking behaviour of the tribal population in India among those with presumptive TB symptoms. |
| title_short |
Understanding health care-seeking behaviour of the tribal population in India among those with presumptive TB symptoms. |
| title_full |
Understanding health care-seeking behaviour of the tribal population in India among those with presumptive TB symptoms. |
| title_fullStr |
Understanding health care-seeking behaviour of the tribal population in India among those with presumptive TB symptoms. |
| title_full_unstemmed |
Understanding health care-seeking behaviour of the tribal population in India among those with presumptive TB symptoms. |
| title_sort |
understanding health care-seeking behaviour of the tribal population in india among those with presumptive tb symptoms. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/89d9556f63e9412788aeee9c90bdf8db |
| work_keys_str_mv |
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