Patient predictors of health-seeking behaviour for persons coughing for more than two weeks in high-burden tuberculosis communities : the case of the Western Cape, South Africa
| dc.contributor.author | Christian, Carmen | en_ZA |
| dc.contributor.author | Burger, Cobus | en_ZA |
| dc.contributor.author | Claassens, Mareli | en_ZA |
| dc.contributor.author | Bond, Virginia | en_ZA |
| dc.contributor.author | Burger, Ronelle | en_ZA |
| dc.date.accessioned | 2019-06-20T13:39:07Z | |
| dc.date.available | 2019-06-20T13:39:07Z | |
| dc.date.issued | 2019 | |
| dc.description | CITATION: Christian, C., et al. 2019. Patient predictors of health-seeking behaviour for persons coughing for more than two weeks in high-burden tuberculosis communities : the case of the Western Cape, South Africa. BMC Health Services Research, 19:160, doi:10.1186/s12913-019-3992-6. | |
| dc.description | The original publication is available at https://bmchealthservres.biomedcentral.com | |
| dc.description | Publication of this article was funded by the Stellenbosch University Open Access Fund. | |
| dc.description.abstract | Background: This study aimed to analyse the patient predictors of health-seeking behaviour for persons coughing for more than 2 weeks to better understand this vulnerable and important population. Methods: The study analysed data from a cohort study (SOCS - Secondary Outcome Cohort Study) embedded in a community randomised trial ZAMSTAR (Zambia and South Africa TB and AIDS Reduction Study) in eight high-burden TB communities in the Western Cape, South Africa. These datasets are unique as they contain TB-related data as well as data on health, health-seeking behaviour, lifestyle choices, employment, socio-economic status, education and stigma. We use uni- and multivariate logistic regressions to estimate the odds ratios of consulting for a cough (of more than 2 weeks duration) for a range of relevant patient predictors. Results: Three hundred and forty persons consulted someone about their cough and this represents 37% of the 922 participants who reported coughing for more than 2 weeks. In the multivariate analysis, respondents of black ethnic origin (OR 1.99, 95% CI 1.28–3.12, P < 0.01), those with higher levels of education (OR 1.05 per year of education, 95% CI 1.00–1.10, P = 0.05), and older respondents (OR 1.02 per year, 95% CI 1.01–1.04, P < 0.01) had a higher likelihood of consulting for their chronic cough. Individuals who smoked (OR 0.63, 95% CI 0.45–0.88, P < 0.01) and those with higher levels of socio-economic status (OR 0.81, 95% CI 0.71–0.92, P < 0.01) were less likely to consult. We find no evidence of stigma playing a role in health-seeking decisions, but caution that this may be due to the difficulty of accurately and reliably capturing stigma due to, amongst other factors, social desirability bias. Conclusions: The low levels of consultation for a cough of more than 2 weeks suggest that there are opportunities to improve case-finding. These findings on health-seeking behaviour can assist policymakers in designing TB screening and active case-finding interventions that are targeted to the characteristics of those with a chronic cough who do not seek care. | en_ZA |
| dc.description.uri | https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-3992-6 | |
| dc.description.version | Publisher's version | |
| dc.format.extent | 8 pages ; illustrations | |
| dc.identifier.citation | Christian, C., et al. 2019. Patient predictors of health-seeking behaviour for persons coughing for more than two weeks in high-burden tuberculosis communities : the case of the Western Cape, South Africa. BMC Health Services Research, 19:160, doi:10.1186/s12913-019-3992-6 | |
| dc.identifier.issn | 1472-6963 (online) | |
| dc.identifier.other | doi:10.1186/s12913-019-3992-6 | |
| dc.identifier.uri | http://hdl.handle.net/10019.1/106283 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | BMC (part of Springer Nature) | |
| dc.rights.holder | Authors retain copyright | |
| dc.subject | Chronic cough | en_ZA |
| dc.subject | Chronic diseases -- Patients -- Western Cape, South Africa -- Psychological aspects | en_ZA |
| dc.subject | Patient participation -- Western Cape, South Africa | en_ZA |
| dc.subject | Tuberculosis -- Patients -- Western Cape, South Africa | en_ZA |
| dc.title | Patient predictors of health-seeking behaviour for persons coughing for more than two weeks in high-burden tuberculosis communities : the case of the Western Cape, South Africa | en_ZA |
| dc.type | Article | en_ZA |