Determinants of health system delay at public and private directly observed treatment, short course facilities in Lagos State, Nigeria: A cross-sectional study

Objective/background: Despite several studies on health system delay (HSD) among tuberculosis (TB) patients in Nigeria, no study has compared HSD in private and public health facilities. This study assessed the determinants of HSD in public and private health facilities offering the directly observe...

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Main Authors: Olusola Adedeji Adejumo, Olusoji James Daniel, Andrew Folarin Otesanya, Esther Ngozi Adejumo
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:International Journal of Mycobacteriology
Subjects:
Online Access:http://www.ijmyco.org/article.asp?issn=2212-5531;year=2016;volume=5;issue=3;spage=257;epage=264;aulast=Adejumo
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spelling doaj-f6ace2581fa54c3fa11d2ffe411049e82020-11-24T21:26:22ZengWolters Kluwer Medknow PublicationsInternational Journal of Mycobacteriology2212-55312212-554X2016-01-015325726410.1016/j.ijmyco.2016.04.004Determinants of health system delay at public and private directly observed treatment, short course facilities in Lagos State, Nigeria: A cross-sectional studyOlusola Adedeji AdejumoOlusoji James DanielAndrew Folarin OtesanyaEsther Ngozi AdejumoObjective/background: Despite several studies on health system delay (HSD) among tuberculosis (TB) patients in Nigeria, no study has compared HSD in private and public health facilities. This study assessed the determinants of HSD in public and private health facilities offering the directly observed treatment, short course (DOTS). Methods: A descriptive cross-sectional study was conducted. A total of 470 new smear-positive TB patients aged 14 years and older were consecutively recruited between October 1, 2012, and December 31, 2012, from 34 (23 public and 11 private) DOTS facilities that offered treatment and microscopy services. Mann–Whitney U test and logistic regression were used to assess the determinants of HSD. Results: The median HSD was longer at public DOTS facilities (14 days; interquartile range [IQR] 10–21 days) than private DOTS facilities (12.5 days; IQR 10.0–14.0 days, p = .002). Age and human immunodeficiency virus status were determinants of HSD at the public DOTS facilities, whereas sex and income were determinants of HSD at the private DOTS facilities. TB patients who first visited a nonhospital facility were over four times more likely (odds ratio 4.12; 95% confidence interval 2.25–7.54) to have prolonged HSD than those who first visited the government hospital when they first developed the symptoms of TB after controlling for other factors in the model. Conclusion: Determinants of HSD at the public and private DOTS facilities vary. Strategies to reduce HSD at both public and private DOTS facilities in Lagos State, Nigeria, are urgently needed.http://www.ijmyco.org/article.asp?issn=2212-5531;year=2016;volume=5;issue=3;spage=257;epage=264;aulast=AdejumoDeterminantsDirectly observed treatmentShort courseHealth system delayLagosTuberculosis
collection DOAJ
language English
format Article
sources DOAJ
author Olusola Adedeji Adejumo
Olusoji James Daniel
Andrew Folarin Otesanya
Esther Ngozi Adejumo
spellingShingle Olusola Adedeji Adejumo
Olusoji James Daniel
Andrew Folarin Otesanya
Esther Ngozi Adejumo
Determinants of health system delay at public and private directly observed treatment, short course facilities in Lagos State, Nigeria: A cross-sectional study
International Journal of Mycobacteriology
Determinants
Directly observed treatment
Short course
Health system delay
Lagos
Tuberculosis
author_facet Olusola Adedeji Adejumo
Olusoji James Daniel
Andrew Folarin Otesanya
Esther Ngozi Adejumo
author_sort Olusola Adedeji Adejumo
title Determinants of health system delay at public and private directly observed treatment, short course facilities in Lagos State, Nigeria: A cross-sectional study
title_short Determinants of health system delay at public and private directly observed treatment, short course facilities in Lagos State, Nigeria: A cross-sectional study
title_full Determinants of health system delay at public and private directly observed treatment, short course facilities in Lagos State, Nigeria: A cross-sectional study
title_fullStr Determinants of health system delay at public and private directly observed treatment, short course facilities in Lagos State, Nigeria: A cross-sectional study
title_full_unstemmed Determinants of health system delay at public and private directly observed treatment, short course facilities in Lagos State, Nigeria: A cross-sectional study
title_sort determinants of health system delay at public and private directly observed treatment, short course facilities in lagos state, nigeria: a cross-sectional study
publisher Wolters Kluwer Medknow Publications
series International Journal of Mycobacteriology
issn 2212-5531
2212-554X
publishDate 2016-01-01
description Objective/background: Despite several studies on health system delay (HSD) among tuberculosis (TB) patients in Nigeria, no study has compared HSD in private and public health facilities. This study assessed the determinants of HSD in public and private health facilities offering the directly observed treatment, short course (DOTS). Methods: A descriptive cross-sectional study was conducted. A total of 470 new smear-positive TB patients aged 14 years and older were consecutively recruited between October 1, 2012, and December 31, 2012, from 34 (23 public and 11 private) DOTS facilities that offered treatment and microscopy services. Mann–Whitney U test and logistic regression were used to assess the determinants of HSD. Results: The median HSD was longer at public DOTS facilities (14 days; interquartile range [IQR] 10–21 days) than private DOTS facilities (12.5 days; IQR 10.0–14.0 days, p = .002). Age and human immunodeficiency virus status were determinants of HSD at the public DOTS facilities, whereas sex and income were determinants of HSD at the private DOTS facilities. TB patients who first visited a nonhospital facility were over four times more likely (odds ratio 4.12; 95% confidence interval 2.25–7.54) to have prolonged HSD than those who first visited the government hospital when they first developed the symptoms of TB after controlling for other factors in the model. Conclusion: Determinants of HSD at the public and private DOTS facilities vary. Strategies to reduce HSD at both public and private DOTS facilities in Lagos State, Nigeria, are urgently needed.
topic Determinants
Directly observed treatment
Short course
Health system delay
Lagos
Tuberculosis
url http://www.ijmyco.org/article.asp?issn=2212-5531;year=2016;volume=5;issue=3;spage=257;epage=264;aulast=Adejumo
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