title: Health-care seeking behaviour for tuberculosis symptoms in Croatia.
abstract: BACKGROUND
  Early detection and treatment of tuberculosis (TB) patients have been key principles of TB control. Therefore, it is important to understand the causes of delay and to estimate their magnitude in order to plan interventions that yield the maximum benefit.
  
  
  METHODS
  A total of 240 subjects aged ≥ 15 year with pulmonary TB were interviewed. Patient delay was defined as the period (in days) from the appearance of any symptoms to the first visit to a medical provider.
  
  
  RESULTS
  The median patient delay was 38 days. When using the median as a cut-off to define long patient delay, being an ex-smoker (P = 0.036), current smoker (P = 0.030), coughing (P = 0.021) and losing weight (P = 0.050) were found to be significant. Having high level of education (P = 0.014) was associated with short delay. Being an ex-smoker (P = 0.050, adjusted odds ratio (aOR) = 1.940, 95% CI 1.001-3.759), current smoker (P = 0.029, aOR = 2.077, 95% CI 1.076-4.012) and having a cough (P = 0.022, aOR = 2.032, 95% CI 1.108-3.727), were significant in multivariate logistic regression, while having high level of education remained associated with short delay (P = 0.016, aOR = 0.286, 95% CI 0.103-0.791). The most common reasons for delay were supposed influenza or symptoms improving over time (34.5%) and underestimated symptoms (32.9%).
  
  
  CONCLUSIONS
  People with smoking habits and health-seeking behaviour that may favour advanced disease and prolonged infectiousness as well as people with the lowest level of education contributed to TB delay. To reduced patient delay, efforts should be made to increase TB knowledge, which has to be adjusted to the less-educated segments of the population.
authors.affiliation: Teaching Public Health Institute of Split and Dalmatia County and School of Medicine, University of Split, Split, Croatia. anamarijajurcev@yahoo.com
authors.forename: Anamarija
authors.initials: A
authors.lastname: Jurcev-Savicevic
authors.forename: Goran
authors.initials: G
authors.lastname: Kardum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003153:Community Health Services / Q000706:statistics & numerical data*; D017523:Croatia / Q000453:epidemiology; D042241:Early Diagnosis; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D055815:Young Adult