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Title: Duration of intervals in the care seeking pathway for lung cancer in Bangladesh: A journey from symptoms triggering consultation to receipt of treatment.
Austin Authors: Ansar, Adnan;Lewis, Virginia;McDonald, Christine F ;Liu, Chaojie;Rahman, Muhammad Aziz 
Affiliation: School of Psychology and Public Health, La Trobe University, Melbourne, Australia
Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
Respiratory and Sleep Medicine
University of Melbourne, Melbourne, Australia
School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, Melbourne, Australia
Institute for Breathing and Sleep
Australian Institute for Primary Care and Aging, La Trobe University, Melbourne, Australia
School of Health, Federation University Australia, Berwick, Australia
Issue Date: 10-Sep-2021 2021
Publication information: PLoS One 2021; 16(9): e0257301
Abstract: Timeliness in seeking care is critical for lung cancer patients' survival and better prognosis. The care seeking trajectory of patients with lung cancer in Bangladesh has not been explored, despite the differences in health systems and structures compared to high income countries. This study investigated the symptoms triggering healthcare seeking, preferred healthcare providers (including informal healthcare providers such as pharmacy retailers, village doctors, and "traditional healers"), and the duration of intervals in the lung cancer care pathway of patients in Bangladesh. A cross-sectional study was conducted in three tertiary care hospitals in Bangladesh among diagnosed lung cancer patients through face-to-face interview and medical record review. Time intervals from onset of symptom and care seeking events were calculated and compared between those who sought initial care from different providers using Wilcoxon rank sum tests. Among 418 study participants, the majority (90%) of whom were males, with a mean age of 57 ±9.86 years, cough and chest pain were the most common (23%) combination of symptoms triggering healthcare seeking. About two-thirds of the total respondents (60%) went to informal healthcare providers as their first point of contact. Living in rural areas, lower levels of education and lower income were associated with seeking care from such providers. The median duration between onset of symptom to confirmation of diagnosis was 121 days, between confirmation of diagnosis and initiation of treatment was 22 days, and between onset of symptom and initiation of treatment was 151 days. Pre-diagnosis durations were longer for those who had sought initial care from an informal provider (p<0.05). Time to first contact with a health provider was shorter in this study compared to other developed and developing countries but utilizing informal healthcare providers caused delays in diagnosis and initiation of treatment. Encouraging people to seek care from a formal healthcare provider may reduce the overall duration of the care seeking pathway.
DOI: 10.1371/journal.pone.0257301
ORCID: 0000-0001-6052-8657
Journal: PLoS One
PubMed URL: 34506592
Type: Journal Article
Appears in Collections:Journal articles

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