↓ Skip to main content

Tuberculosis patients’ pre-hospital delay and non-compliance with a longstanding DOT programme: a mixed methods study in urban Zambia

Overview of attention for article published in BMC Public Health, October 2016
Altmetric Badge

Mentioned by

twitter
2 X users

Citations

dimensions_citation
13 Dimensions

Readers on

mendeley
155 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Title
Tuberculosis patients’ pre-hospital delay and non-compliance with a longstanding DOT programme: a mixed methods study in urban Zambia
Published in
BMC Public Health, October 2016
DOI 10.1186/s12889-016-3771-9
Pubmed ID
Authors

Anne Lia Cremers, René Gerrets, Nathan Kapata, Austin Kabika, Emma Birnie, Kerstin Klipstein-Grobusch, Martin P. Grobusch

Abstract

Tuberculosis (TB) remains a major health problem in Zambia, despite considerable efforts to control and prevent it. With this study, we aim to understand how perceptions and cultural, social, economic, and organisational factors influence TB patients' pre-hospital delay and non-compliance with care provided by the National Tuberculosis Programme (NTP). A mixed methods study was conducted with 300 TB patients recruited at Kanyama clinic for structured interviews. Thirty were followed-up for multiple in-depth interviews. Six focus group discussions were organised and participant observation was conducted. Ten biomedical care providers, 10 traditional healers, and 10 faith healers were interviewed. Factors associated with non-compliance (disruption of treatment > one week) were assessed by applying logistic regression analyses; qualitative analysis was used to additionally assess factors influencing pre-hospital delay and for triangulation of study findings. TB treatment non-compliance was low (10 %), no association of outcome with cultural or socio-economic factors was found. Only patients' time constraints and long distance to the clinic indicated a possible association with a higher risk of non-compliance (OR 0.52; 95 % CI 0.25, 1.10, p = 0.086). Qualitative data showed that most TB patients combined understandings of biomedical and traditional TB knowledge, used herbal, traditional and/or faith healing, suffered from stigmatizing attitudes, experienced poverty and food shortages, and faced several organisational obstacles while being on treatment. This led in some cases to pre-hospital delay or treatment non-compliance. Mixed methods analysis demonstrated the importance of in-depth information ascertained by qualitative approaches to understand how cultural, socio-economic and organisational factors are influencing patients' pre-hospital delay and treatment compliance. To strengthen the Zambian NTP, combating stigma is of utmost priority coupled with programmes addressing poverty. Organisational barriers and co-operation between (private) clinics and traditional/faith healers should be considered.

X Demographics

X Demographics

The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 155 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 155 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 24 15%
Student > Master 22 14%
Student > Ph. D. Student 13 8%
Student > Bachelor 12 8%
Student > Postgraduate 10 6%
Other 24 15%
Unknown 50 32%
Readers by discipline Count As %
Nursing and Health Professions 35 23%
Medicine and Dentistry 29 19%
Social Sciences 13 8%
Biochemistry, Genetics and Molecular Biology 3 2%
Psychology 3 2%
Other 16 10%
Unknown 56 36%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 November 2016.
All research outputs
#18,480,433
of 22,899,952 outputs
Outputs from BMC Public Health
#12,910
of 14,930 outputs
Outputs of similar age
#237,040
of 313,743 outputs
Outputs of similar age from BMC Public Health
#184
of 217 outputs
Altmetric has tracked 22,899,952 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 14,930 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.9. This one is in the 6th percentile – i.e., 6% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 313,743 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 13th percentile – i.e., 13% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 217 others from the same source and published within six weeks on either side of this one. This one is in the 5th percentile – i.e., 5% of its contemporaries scored the same or lower than it.