抄録
The objective of the study was to determine the burden of pulmonary tuberculosis (PTB) in a rural Papua New Guinea (PNG) setting using an active case detection approach and to describe the health seeking behavior of prolonged cough patients. A cross-sectional, house-to-house survey was carried out in November 2005 to March 2006 in rural communities in Sum Kar district, Madang Province to identify the prolonged cough patients. Sputum from prolonged cough patients was collected to confirm the presence of PTB with acid fast bacilli (AFB) microscopy. Questionnaire survey and semi-structured interviews were carried out to explore factors related to health-seeking behavior. A total of 184 of 7,311 (2.5%) people (aged≥15 years) reported prolonged cough, and 15 new PTB cases (205/100,000) were diagnosed and detected from the survey. Passive case finding detected only 32% of all PTB cases, whereas approximately 40% of PTB cases had never sought care at any forms of health facilities. Those seeking health care did so within 16 days after onset of cough. The health system’s delay, however, was pronounced, with an overall median delay of 12 months. Closer distance to the health center and the severity of clinical conditions were significant factors for promptly seeking health care. The PNG TB control program would need to improve PTB diagnosis capacity at rural health facilities as well as integrate an active case finding approach into the program.
