부산대학교 도서관

Background: In Bangladesh there are around 300,000 new cases of TB every year with 70,000 deaths. In spite of major national and global efforts obstacles to effective diagnosis and treatment still persist. This study sets out to assess factors like socio- economic and demographic characteristics, patients care seeking pattern, average cost etc.in north eastern part of Bangladesh. Methods: This cross sectional study was done by interviewing systematically selected patients in two urban and two semi-urban DOTS center from July 2012 to June 2013 using a structured questionnaire considering socio-economic status, care seeking pattern, money spent for diagnosis & treatment and quality of service etc. Sputum smear positive patients aged = 19 years receiving treatment for = four weeks were enrolled. Chi-square test was done to explore the level of signifi cance. Results: Out of 170 patient`s majority (76; 44.7%) was belonged to most economically productive age group (25-44 years). About one third (59; 34.7%) patients were the only earning member of the family and majority (131; 77.05%) of them was not working due to current illness (p = 0.005). Delay in diagnosis (117; 68.82%) was common ((p = 0.005) among semi-urban patients while they (121; 71.1%) also experienced signifi - cant (p = 0.005) delay (> 3 weeks) to reach the DOTS corner and spent more money (> 15 USD) to confi rm their diagnosis compared to urban counterpart (p = 0.005). 70% patients utilized private health care services initially and fear of government formalities (87; 73.1%) was the most common reason for that. Total 27.05% participants suspect about quality of drug. Conclusions: The linkage between TB and poor socio economic condition is well documented. Policy makers should implement “pro-poor bias” in their TB strategies. Regular monitoring is essential to overcome the barriers.