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...
Main Authors: | , , , |
---|---|
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 |
id |
doaj-f6ace2581fa54c3fa11d2ffe411049e8 |
---|---|
record_format |
Article |
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 |
work_keys_str_mv |
AT olusolaadedejiadejumo determinantsofhealthsystemdelayatpublicandprivatedirectlyobservedtreatmentshortcoursefacilitiesinlagosstatenigeriaacrosssectionalstudy AT olusojijamesdaniel determinantsofhealthsystemdelayatpublicandprivatedirectlyobservedtreatmentshortcoursefacilitiesinlagosstatenigeriaacrosssectionalstudy AT andrewfolarinotesanya determinantsofhealthsystemdelayatpublicandprivatedirectlyobservedtreatmentshortcoursefacilitiesinlagosstatenigeriaacrosssectionalstudy AT estherngoziadejumo determinantsofhealthsystemdelayatpublicandprivatedirectlyobservedtreatmentshortcoursefacilitiesinlagosstatenigeriaacrosssectionalstudy |
_version_ |
1725980249563332608 |