Time to appropriate care-seeking for Covid - 19 symptoms

ABSTRACT

Background. in sub-Saharan Africa, the symptoms of covid-19 are similar to those of several pathologies frequently encountered in this region, which can confuse the diagnosis both for the patient and for health structures with limited resources. We studied self-reported time to care-seeking from the onset of covid-19 symptoms. Methods. This was a cross-sectional study. Patient'files who attended the medical emergencies Unit of Brazzaville University Hospital, for symptoms suggestive of Covid - 19 between May 2020 and February 2022, were collected. The diagnosis of Covid-19 was confirmed by RT-PCR or antigen test. Delay, between the rise of Covid- 19 symptoms and the attendance at the medical emergencies Unit, was recovered from the history of the disease reported by the patients themselves. When the patient had reported a duration of 'about one week' in the delay we noted '7 days' and 'about 2 weeks' corresponded to '14 days' taking this into account we used the Weibull regression model accelerated failure-time metric to identify potential risk factors which were subsequently presented as a time ratio (TR). Results. 102 patients were included, 57 (55.88%) were women, the median age was 64 years (Interquartile Range (IQR) 56 - 71), history of hypertension and diabetes was found respectively in 51 (50%) and 27 (26.47%) patients. 13 (12.75%) were vaccinated against Covid - 19. The median time to care-seeking was 7 days (IIQ 5 - 7). Being vaccinated (adjusted Time Ratio (aTR) 1.69 (95% CI 1.09 - 2.6) p=0.02) and having a cough (aTR 1.74 (95% CI 1.2 - 2.52) p=0.03) was associated with a longer time to care-seeking. On the other hand, being Hypertensive (aTR 0.68 (95% CI 0.51 - 0.9) p= 0.006), asthenic (aTR 0.46 (95% CI 0.23 - 0.91) p= 0.03) and having respiratory distress (aTR 0.48 (95% CI 0.26 - 0.89) p=0.03) were associated with a faster time to care-seeking. Conclusion. the vaccine increases time for care-seeking, especially when it is associated with the classic signs of COVID-19 such as cough. To limit the undernotification of cases in sub-Saharan Africa, Covid 19 testing must be generalized.