Document Detail


Factors contributing to delay in diagnosis and start of treatment of leprosy: analysis of help-seeking narratives in northern Bangladesh and in West Bengal, India.
MedLine Citation:
PMID:  15881034     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of our research was to identify factors contributing to delay in diagnosis and start of treatment in leprosy, focussing on patients' narratives of help-seeking behaviour. Our research took place in Purulia, West Bengal, India and in Nilphamari, northern Bangladesh. Between January and August 2000, we conducted semi-structured interviews with 104 patients that explored each individual's narrative of help-seeking behaviour and the context of beliefs and attitudes towards leprosy. Subsequently we surveyed 356 patients currently receiving treatment for leprosy and recorded specific aspects of each help-seeking action and their reports of local beliefs and attitudes towards leprosy. Delay was estimated from time of first symptoms through to start of effective treatment (mean 18 months, median 9 months in Purulia and mean 20 months, median 12 months in Nilphamari). The number of help-seeking actions ranged from 1 to 7. Time committed to first actions contributed 86% (Nilphamari) and 79% (Purulia) to total delay. The most important contributor to delay in the first action occurred when people simply monitored or ignored first symptoms, 80% in Nilphamari and 67% in Purulia. With delay longer than 12 months as outcome, logistic regression analyses identified age over 35 years, multiple visits to practitioners in traditional medicine and multiple visits to health service practitioners as predictive of delay. Attending a nearby clinic and exposure to health education materials were predictive of early presentation reduced delay.
Authors:
P G Nicholls; N Chhina; A K Bro; P Barkataki; R Kumar; S G Withington; W C S Smith
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Leprosy review     Volume:  76     ISSN:  0305-7518     ISO Abbreviation:  Lepr Rev     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-05-09     Completed Date:  2005-06-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0243711     Medline TA:  Lepr Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  35-47     Citation Subset:  IM    
Affiliation:
Department of Public Health, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, Scotland, UK. nicholls@fish.co.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Attitude to Health*
Bangladesh / epidemiology
Cohort Studies
Female
Humans
India / epidemiology
Leprosy / diagnosis*,  epidemiology,  therapy*
Male
Patient Acceptance of Health Care*
Time Factors
Waiting Lists*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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