||Beyers N, Gie RP, Hchaaf HS, van Zyl S, Nel ED, Talent
JM & Donald PR
||Delay in diagnosis, notification and initiation of
treatment and compliance with tuberculosis.
||TUBERCLE & LUNG DIS 1994, 75, 260-265
The mortality and morbidity from childhood TB may
be influenced by the delay from the time of first symptoms until
the start of and compliance with treatment. This study investigated
these delay periods and the compliance with therapy in children
with TB. During the study period in Cape Town, S. Africa, there
were 49 children with probable and 123 with confirmed pulmonary
TB (WHO criteria). The mean period from first symptoms until presentation
was 4.3 weeks, from presentation until notification 5 weeks and
from notification until therapy 0.9 weeks. Sixteen percent of children
notified as having TB never received therapy. Significantly fewer
children in the urban squatter communities received therapy than
in urban settled (P = 0.02), rural agricultural (P = 0.0001) and
rural settled (P = 0.09) communities. Twelve percent of the children
did not complete their therapy. The delay in presentation (patient
delay) was shorter than the delay in diagnosis (doctor
delay). Failure to trace children and to complete therapy
was particularly likely to occur in urban squatter communities.
Easier access to health care facilities may shorten the patient
delay, while greater awareness of TB and proper investigation
of children may shorten the doctor delay.
|KEYWORDS: COMPLIANCE; DELAY; SOUTH AFRICA.