Four Degrees of Separation: Social Contacts and Health Providers Influence the Steps to Final Diagnosis of Active Tuberculosis Patients in Urban Uganda

Table 3 Step patterns and person- days in diagnostic pathway by social and health provider contacts among 294 TB patients

Step patterns
From	To	Steps pairs^c (%)	Total person- days^d (%)	Median person-days^e [IQR]	Number of patients in step^f
All steps		1,555	32,011	14 (3,27)	294
Self	Social contact	171 (11)	7249 (23)	28 (14,53)	171
Self	Non-TB provider	87 (5.4)	4009 (12)	29 (16,62)	87
Self	TB provider, no diagnosis^b	27 (2)	1353 (4)	54 (18,69)	27
Self	TB provider, final diagnosis^a	9 (0.6)	609 (2)	68 (21,91)	9
Self	Any contact	294 (19)	13,220 (41)	29 (16,58)	294
Social contact	Social contact	30 (2.4)	515 (2)	14 (2,19)	26
Social contact	Non-TB provider	171 (11)	2364 (7)	14 (2,14)	141
Social contact	TB provider, no diagnosis^b	77 (5)	1123 (4)	7 (1,14)	75
Social contact	TB provider, final diagnosis^a	73 (4.6)	456 (1)	2 (1,14)	73
Social contact	Any contact	351 (23)	4458 (14)	7 (7,77)	315
Non-TB provider	Social contact	135 (9)	1746 (5)	7 (2,14)	92
Non-TB provider	Non-TB provider	405 (26)	6801 (21)	14 (7,21)	139
Non-TB provider	TB provider, no diagnosis^b	43 (3)	825 (3)	14 (3,26)	41
Non-TB provider	TB provider, final diagnosis^a	118 (7)	1500 (5)	7 (1,14)	118
Non-TB provider	Any contact	701 (45)	10,872 (34)	14 (7,30)	390
TB provider, no diagnosis	Social contact	15 (0.9)	260 (0.8)	14 (3,22)	14
TB provider, no diagnosis	Non-TB Provider	38 (2.1)	696 (2.2)	11 (4,30)	37
TB provider, no diagnosis	TB provider, no diagnosis^b	62 (4)	1551 (5)	14 (5,30)	36
TB provider, no diagnosis	TB provider, final diagnosis^a	94 (6)	952 (3)	3 (1,14)	94
TB provider, no diagnosis	Any contact	209 (13)	3459 (11)	7 (3,17)	181
All steps		1,555	32,011	14 (3,27)	294

Self = Symptom onset or recognition
TB Provider = Gov’t hospital, health center and private hospital
Non-TB providers = Herbal healer, private clinics, drugs stores, village health worker
Social Contact = Parent, spouse, siblings, adult child, other relative, friend, co-worker, neighbor
^aTB provider where final diagnosis took place; all patients performed this step only once
^bTB provider, no diagnosis where a TB diagnosis was not made in the step
^cTotal step pairs capture patients’ movements between two contact points along their pathway
^dTotal time represents cumulative person-days spent in a given step pair by all patients who performed it
^eMedian person-days spent by patients who performed each step pair
^fNumber of patients taking steps, this may exceed N = 294 because some patients performed the same step pairs more than once

ISSN: 1471-2334