Individual journeys to tuberculosis care in Nigeria’s private sector during the Covid-19 pandemic

Bibliographic Data

ID21881527
AuthorsCharity Oga‐Omenka (0000-0003-0779-570X, University of Waterloo, corresponding author), Lauren Rosapep (0000-0001-8475-9388, African Field Epidemiology Network), Elaine Baruwa (ABT Associates Inc Bethesda, Bethesda, Maryland, USA), Elaine M Baruwa (0000-0001-6958-7004, African Field Epidemiology Network), Lavanya Huria (0000-0002-7835-0372, McGill University Health Centre), Nathaly Aquilera Vasquez (McGill University Health Centre), Bolanle Olusola Faleye (African Field Epidemiology Network), Md Abdullah Heel Kafi (McGill University Health Centre), Angelina Sassi (0000-0002-5807-6388, McGill University Health Centre), Chimdi Nwosu (VizSight Analytics Inc, Vancouver, British Columbia, Canada), Benjamin Johns (0000-0002-2892-6089, Abt Global (United States)), Abdu A Adamu (0000-0003-3317-1319, African Field Epidemiology Network), Abdu Adamu (Sustaining Health Outcomes through the Private Sector (SHOPS) Plus, Abuja, Nigeria), Obioma Chijioke-Akaniro (0000-0001-7906-0521, National TB & Leprosy Control Program, Abuja, Nigeria), Chukwuma Anyaike (0000-0002-3570-5831, National TB & Leprosy Control Program, Abuja, Nigeria), Madhukar Pai (0000-0003-3667-4536, McGill University Health Centre)
Year2024
Volume9
Issue1
Pagese013124
Publication date2024-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2023-013124
PMID38195153
OpenAlexW4390699857
LanguageEN
Citations received4
References cited65

BACKGROUND: Pre-COVID-19, individuals with tuberculosis (TB) in Nigeria were often underdiagnosed and untreated. TB services were mostly in the public sector with only 15% of new cases in 2019 reported from the private sector. Reports highlighted challenges in accessing care in the private sector, which accounted for 67% of all initial care-seeking. Our study examined patients' health seeking pathways for TB in Nigeria's private sector and explored any changes to care pathways during COVID-19. METHODS: We conducted 180 cross-sectional surveys and 20 in-depth interviews with individuals having chest symptoms attending 18 high-volume private clinics and hospitals in Kano and Lagos States. Questions focused on sociodemographic characteristics, health-seeking behaviour, and pathways to care during the COVID-19 pandemic. All surveys and interviews were conducted in May 2021. RESULTS: Most participants were male (111/180), with an average age of 37. Half (96/180) sought healthcare within a week of symptoms, while few (20/180) waited over 2 months. Individuals testing positive for TB had more health-seeking delays, and those testing negative for TB had more provider delays. On average, participants visited two providers in Kano and 1.69 in Lagos, with 61 of 180 in Kano and 48 of 180 in Lagos visiting other providers before the recruitment facility. Private providers were the initial encounters for most participants (60/180 in Kano, 83/180 in Lagos). Most respondents (164/180) experienced short-lived pandemic-related restrictions, affecting access to transportation, and closed facilities. CONCLUSIONS: This study showed a few challenges in accessing TB care, necessitating continued investment in healthcare infrastructure and resources, particularly in the private sector. Understanding the different care pathways and delays in care provides opportunities for targeted interventions to improve deployment of services closer to where patients first seek care

Disease · Economic growth · Environmental health · Family medicine · Health care · Health facility · Health services · Pandemic · Political science · Population · Private sector · Public health · Public sector · Tuberculosis · Diagnosis and treatment of tuberculosis · Healthcare Facilities Design and Sustainability · Medicine · Nursing · Tuberculosis Research and Epidemiology