title: Patient Reported Delays in Seeking Treatment for Tuberculosis among Adult and Pediatric TB Patients and TB Patients Co-Infected with HIV in Lima, Peru: A Qualitative Study.
abstract: BACKGROUND
  Tuberculosis (TB) remains a significant public health challenge worldwide, and particularly in Peru with one of the highest incidence rates in Latin America. TB patient behavior has a direct influence on whether a patient will receive timely diagnosis and successful treatment of their illness.
  
  
  OBJECTIVE
  The objective was to understand the complex factors that can impact TB patient health seeking behavior.
  
  
  METHODS
  In-depth interviews were conducted with adult and parents of pediatric patients receiving TB treatment (n = 43), within that group a sub-group was also co-infected with HIV (n = 11).
  
  
  RESULTS
  Almost all of the study participants recognized delays in seeking either their child's or their own diagnosis of their TB symptoms. The principal reasons for treatment-seeking delays were lack of knowledge and confusion of TB symptoms, fear and embarrassment of receiving a TB diagnosis, and a patient tendency to self-medicate prior to seeking formal medical attention.
  
  
  CONCLUSIONS
  Health promotion activities that target patient delays have the potential to improve individual patient outcomes and mitigate the spread of TB at a community level.
authors.affiliation: Tulane University School of Public Health and Tropical Medicine , New Orleans, LA , USA ; Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia , Lima , Peru.
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Paz-Soldan
authors.affiliation: Tulane University School of Public Health and Tropical Medicine , New Orleans, LA , USA.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Alban
authors.affiliation: Tulane University School of Public Health and Tropical Medicine , New Orleans, LA , USA.
authors.forename: Christy
authors.initials: C
authors.lastname: Dimos Jones
authors.affiliation: Tulane University School of Public Health and Tropical Medicine , New Orleans, LA , USA.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Powell
authors.affiliation: Tulane University School of Public Health and Tropical Medicine , New Orleans, LA , USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Oberhelman
keywords: HIV; Latin America; delayed diagnosis; qualitative research; tuberculosis