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Impact of Protracted Displacement on Delay in the Diagnosis Associated with Treatment Outcomes: A Cross-Sectional Study in Internally Displaced Tuberculosis Patients of Pakistan

Author

Listed:
  • Farman Ullah Khan

    (Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

  • Faiz Ullah Khan

    (Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

  • Khezar Hayat

    (Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

  • Jie Chang

    (Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

  • Muhammad Kamran

    (Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan)

  • Asad Khan

    (Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan)

  • Usman Rashid Malik

    (Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

  • Asif Khan

    (District Bannu TB Control Program Unit, Headquarter Hospital Bannu, Bannu 28100, Pakistan)

  • Yu Fang

    (Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China
    Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
    Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an 710061, China
    Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi’an 710061, China)

Abstract

Human displacement is on the rise globally, and the increase in the burden of tuberculosis (TB) is also attributed to migrations worldwide. A significant number of such displacements occur in regions with considerably higher areas of TB burden. Displacements may delay TB diagnosis and treatment, which will possibly lead to TB transmission among healthy individuals. In this study, we assessed the association of existing determinants after a protracted internal displacement of people with delay in TB diagnosis and treatment outcomes. A cross-sectional study was conducted on internally displaced TB patients (IDPs), registered at selected health facilities in three urban districts of Pakistan from March 2019 to February 2020. The univariate and multivariate logistic regression model was used to assess the delay in diagnosis and treatment outcomes. IDPs with delay in initiation of treatment beyond 30 days were at high possibility of unsuccessful TB treatment outcomes (adjusted odds ratio AOR, 2.60; 95% CI 1.06–6.40). Furthermore, the multivariate regression analysis showed a statistically significant association ( p > 0.05) between TB patients who were aged 55 to 65 years (AOR, 2.66; 95% CI 1.00–7.07), female patients (AOR, 2.42; 95% CI 1.21–4.81), visited non-formal health provider (AOR, 8.81; 95% CI 3.99–19.46), self-medication (AOR, 2.72; 95 % CI 1.37–5.37), poor knowledge of TB (AOR, 11.39; 95% CI 3.31–39.1), and perceived stigma (AOR, 8.81; 95% CI 3.99–19.4). Prolonged delay in treatment was associated with unfavorable treatment outcomes among IDPs. Migrants and IDPs are more likely to experience an interruption in care due to overall exclusion from social and health care services. Therefore, it is imperative to understand the barriers to providing public health care services, particularly in preventing and treating TB.

Suggested Citation

  • Farman Ullah Khan & Faiz Ullah Khan & Khezar Hayat & Jie Chang & Muhammad Kamran & Asad Khan & Usman Rashid Malik & Asif Khan & Yu Fang, 2021. "Impact of Protracted Displacement on Delay in the Diagnosis Associated with Treatment Outcomes: A Cross-Sectional Study in Internally Displaced Tuberculosis Patients of Pakistan," IJERPH, MDPI, vol. 18(22), pages 1-14, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:22:p:11984-:d:679609
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    References listed on IDEAS

    as
    1. Florian M Marx & Lena Fiebig & Barbara Hauer & Bonita Brodhun & Gisela Glaser-Paschke & Klaus Magdorf & Walter Haas, 2015. "Higher Rate of Tuberculosis in Second Generation Migrants Compared to Native Residents in a Metropolitan Setting in Western Europe," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-13, June.
    2. Daniele Maria Pelissari & Fredi Alexander Diaz-Quijano, 2017. "Household crowding as a potential mediator of socioeconomic determinants of tuberculosis incidence in Brazil," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-13, April.
    3. Jing Cai & Xianhua Wang & Aiguo Ma & Qiuzhen Wang & Xiuxia Han & Yong Li, 2015. "Factors Associated with Patient and Provider Delays for Tuberculosis Diagnosis and Treatment in Asia: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-22, March.
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    Cited by:

    1. Farman Ullah Khan & Asim ur Rehman & Faiz Ullah Khan & Khezar Hayat & Amjad Khan & Nafees Ahmad & Jie Chang & Usman Rashid Malik & Yu Fang, 2022. "Assessment of Factors Associated with Unfavorable Outcomes among Drug-Resistant TB Patients: A 6-Year Retrospective Study from Pakistan," IJERPH, MDPI, vol. 19(3), pages 1-13, January.

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