PLoS ONE (Jan 2021)

Understanding health care-seeking behaviour of the tribal population in India among those with presumptive TB symptoms.

  • 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

DOI
https://doi.org/10.1371/journal.pone.0250971
Journal volume & issue
Vol. 16, no. 5
p. e0250971

Abstract

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Background and objectivesUnderstanding 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.MethodologyThis 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.ResultsAmong 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 ConclusionDelayed 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.