title: Health-care seeking among people with cough of 2 weeks or more in India. Is passive TB case finding sufficient?
abstract: METHODS
  Thirty districts of India.
  
  
  OBJECTIVE
  To estimate 1) the proportion of people with cough of ≥2 weeks, 2) those who did not seek care from a health care provider for cough, and 3) their characteristics.
  
  
  METHODS
  A cross-sectional community-based survey in which 4562 people (aged ≥18 years) were interviewed.
  
  
  RESULTS
  Of the 4562 individuals interviewed, 437 (9.5%, 95%CI 7.2-11.8) had cough ≥2 weeks; this was more frequent in those >55 years of age (14%) and in those from districts in eastern (12%) and northern (11%) states of India. Of those with cough, 300 (69%, 95%CI 60-77) had not sought care from any health care provider. Not seeking care was more frequent in people residing in rural areas (73%) compared with urban areas (53%), and in the districts of eastern (82%) and northern (74%) states compared to districts from the southern (46%) and western (54%) states.
  
  
  CONCLUSIONS
  Nearly a tenth of those interviewed aged ≥18 years had cough of ≥2 weeks. About two thirds, especially those from rural areas, had not visited a health care provider for the cough. This finding has huge implications for India's current mostly passive case-finding strategy for detecting and controlling tuberculosis.
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Satyanarayana
authors.affiliation: World Health Organization India Country Office, New Delhi, India.
authors.forename: S A
authors.initials: SA
authors.lastname: Nair
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India.
authors.forename: S S
authors.initials: SS
authors.lastname: Chadha
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India.
authors.forename: G
authors.initials: G
authors.lastname: Sharma
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Yadav
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Mohanty
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India.
authors.forename: V
authors.initials: V
authors.lastname: Kamineni
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India.
authors.forename: N C
authors.initials: NC
authors.lastname: Wilson
authors.affiliation: The Union, Paris, France ; London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
keywords: India; case finding; cough; early diagnosis; health-seeking behaviour; symptoms; tuberculosis