title: How did the TB patients reach DOTS services in Delhi? A study of patient treatment seeking behavior.
abstract: METHODS
  Revised National Tuberculosis Control Programme (RNTCP), Delhi, India.
  
  
  OBJECTIVE
  To ascertain the number and sequence of providers visited by TB patients before availing treatment services from DOTS; to describe the duration between onset of symptoms to treatment.
  
  
  METHODS
  A cross sectional, qualitative study. Information was gathered through in-depth interviews of TB patients registered during the month of Oct, 2012 for availing TB treatment under the Revised National TB Control Programme from four tuberculosis diagnosis and treatment centers in Delhi.
  
  
  RESULTS
  Out of the 114 patients who registered, 108 participated in the study. The study showed that informal providers and retail chemists were the first point of contact and source of clinical advice for two-third of the patients, while the rest sought medical care from qualified providers directly. Most patients sought medical care from more than two providers, before being diagnosed as TB. Female TB patients and patients with extra-pulmonary TB had long mean duration between onset of symptoms to initiation of treatment (6.3 months and 8.4 months respectively).
  
  
  CONCLUSIONS
  The pathways followed by TB patients, illustrated in this study, provide valuable lessons on the importance of different types of providers (both formal and informal) in the health system in a society like India and the delays in the diagnosis and treatment of tuberculosis.
authors.affiliation: Harrow Medical Centre, Noida, India. sunil_kapoor96@yahoo.com
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Kapoor
authors.forename: A Venkat
authors.initials: AV
authors.lastname: Raman
authors.forename: Kuldeep Singh
authors.initials: KS
authors.lastname: Sachdeva
authors.forename: Srinath
authors.initials: S
authors.lastname: Satyanarayana
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003710:Demography; D023801:Directly Observed Therapy; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D014376:Tuberculosis / Q000188:drug therapy*; D055815:Young Adult