Abstract

The aim of this study was to investigate the patterns of health care seeking behavior and to identify the influential factors of the same behavior among community level tuberculosis (TB) suspects in Wuhan city, and to provide an appropriate method and relevant references to increase the detection rate for TB. We followed a cluster proportional sampling procedure to select the four study communities (clusters), a total of 5878 people above 15 years old. Subjects with continuous sputum coughing for more than two weeks, or subjects, who were found to be hemoptysis and with blood sputum, six months prior to the survey were included as research subjects, whom would be participants of an interview with questionnaires and receive X-ray examination, three sputum smear and sputum culture check from May to July in 2010. Chi-square test and logistic regression were used to analyze the influencing factors of health care seeking behavior among TB suspects. A total of 270 cases of TB suspects were interviewed and 259 questionnaires were eligible. 79 cases (30.5%) did not seek any health care, 86 cases (33.2%) have sought medical assistance from primary health care centers or general hospitals, 89 cases (34.4%) self-medicated, while 5 cases (1.9%), consulted a private practitioner. A logistic regression analysis revealed that the presence of health insurance (odd ratio (OR)=3.405, 95% confidence interval (CI)=1.018 to 11.392) was relevant to the formal visitation of TB suspects; the difference was significant (P<0.05). With the severe or chronic respiratory symptom (OR=4.959, 95%CI=2.548 to 9.652), no stigmatization (OR=2.528, 95%CI=1.317 to 4.853) were relevant to the formal visitation of TB suspects; the difference was highly significant (P<0.01). The proportion of TB suspects who had actively sought health care was low. The health insurance, severe or chronic respiratory symptom and stigmatization were the main influential factors upon heath care seeking behavior among community level TB suspects.

Key words: Tuberculosis, suspects, health care seeking behavior