Behaviour patterns of persons with chest symptoms in Karnataka state
Nair, S.S.; Radhakrishna, S.; Seetha, M.A.; Samuel, G.E.R.
Indian Journal of Tuberculosis 49(1): 39-48
2002
ISSN/ISBN: 0019-5707 Document Number: 254277
A community survey was conducted in representative rural and urban populations in Karnataka, India, between August 1997 and January 1998, to ascertain the time taken in seeking care among persons with chest symptoms (CS; cough of 3 weeks or more) of tuberculosis in the preceding 6 months and get details about the health care providers consulted, investigations undertaken and costs incurred. Representative samples of 10 000 urban and 10 000 rural people each from 2 districts in Karnataka (Mysore and Raichur) were interviewed. The prevalence of CS in the preceding 6 months was 1.2%. The prevalence was 1.6% among males and 0.9% among females, and increased with age from 0.6% in 15-34 years age group to 2.5% in 35-54 years age group. The vast majority of CS (81% in Mysore and 93% in Raichur) approached general health facilities for symptom relief and most of them (64% in Mysore and 77% in Raichur) restricted themselves to attending only one facility. Private doctors were the most common first choice (average 65%), the reasons being proximity to home, convenient working hours and a perception of good quality care. About 40% sought health care within 7 days, 67% within 15 days and 81% within one month of symptoms with a median interval of only 12 days. Sputum examination was undertaken for only 35% of CS over an average of 8 encounters. The average total costs incurred by CS was substantially higher in urban areas than in rural areas. It is suggested that improvement in diagnostic and treatment services in the health system, rather than general health education, should be given priority.