title: Health-seeking behaviour among adults with prolonged cough in Vietnam.
abstract: OBJECTIVE
  To assess health-seeking behaviour among adults with prolonged cough in a population-based, nationally representative sample in Vietnam.
  
  
  METHODS
  Cross-sectional survey conducted from September 2006 to July 2007. All inhabitants aged ≥15 years were invited for screening for cough, history of tuberculosis (TB) treatment and chest X-ray (CXR) examination. TB suspects, defined as any survey participant with CXR abnormalities consistent with TB, or productive cough for more than 2 weeks or TB treatment either currently or in the preceding 2 years submitted sputum specimens for smear examination and culture and provided information on health-seeking behaviour in an in-depth interview.
  
  
  RESULTS
  Of 94 179 persons participating in the survey, 4.6% had prolonged productive cough. Forty-four percentage of those had sought health care and reported pharmacies (35%), commune health posts (29%), public hospitals (24%) and private physicians (10%) as first point of contact. Only 7% had undergone sputum smear examination. Of TB suspects with prolonged productive cough, 2.9% were diagnosed with TB; 10.2% of these reported smear and 21.9% reported X-ray examination when visiting a health care facility. The average patient delay was 4.1 weeks (95% CI: 3.9-4.4) among cough suspects and 4.0 weeks (95% CI: 3.1-4.9) among TB cases.
  
  
  CONCLUSIONS
  In this Vietnamese survey, nearly half of persons with cough for more than 2 weeks had visited a health care provider. The commonest first health facility contacted was the pharmacy. Sputum smears were rarely examined, except in the provincial TB hospital. Our findings highlight the need to improve diagnostic practices by retraining health staff on the performance of sputum examination for TB suspects.
authors.affiliation: National Tuberculosis Programme Vietnam, Hanoi, Vietnam. nguyenbinhhoatb@yahoo.com
authors.forename: N B
authors.initials: NB
authors.lastname: Hoa
authors.forename: E W
authors.initials: EW
authors.lastname: Tiemersma
authors.forename: D N
authors.initials: DN
authors.lastname: Sy
authors.forename: N V
authors.initials: NV
authors.lastname: Nhung
authors.forename: M
authors.initials: M
authors.lastname: Vree
authors.forename: M W
authors.initials: MW
authors.lastname: Borgdorff
authors.forename: F G J
authors.initials: FG
authors.lastname: Cobelens
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003371:Cough / Q000382:microbiology*; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D015438:Health Behavior; D006801:Humans; D057226:Information Seeking Behavior; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis*; D014505:Urban Population / Q000706:statistics & numerical data; D014744:Vietnam / Q000453:epidemiology