Late reporting for health care among patients presenting with oral maxillofacial tumours or tumourlike lesions in Muhimbili National Hospital, Tanzania

Abstract

Introduction: In developing countries patients with oro-facial tumours present for health care rather late with advanced disease, a situation that complicates management and negatively influences prognosis.

Objective: To determine the reasons for late reporting for health care among patients with tumours and tumour-like lesions in the maxillofacial region attending the Muhimbili National Hospital.

Materials and Methods: This was a descriptive cross-sectional study, which involved 144 patients with either tumours or tumour-like lesions in the oral and maxillofacial region. The study was conducted at the oral and maxillofacial surgery firm of the Muhimbili National Hospital (MNH). A structured questionnaire that was translated to Swahili language was used to gather information. The diagnosis was obtained from the histopathology department of the MNH. Data were analysed using SPSS version 20. Ethical clearance was obtained from the ethical committee of Muhimbili University of Health and Allied Sciences (MUHAS).

Results: Findings revealed that 55.6% of the patients lived near health facilities (dispensaries, health centres or hospitals) which did not offer oral health services. The average time of reporting after a referral from primary health facilities was rather long (69 weeks). Ameloblastoma was the frequently encountered benign tumour and squamous cell carcinoma was the commonest malignant neoplasm. The absence of pain, transport and treatment costs, lack of perception that the lesion was a problem, attending to traditional healers and the use of herbal medicines were reported to be main reasons for the delay in reporting for health care. The odds of reporting late to the referral hospital was three folds higher in patients who had delayed to seek treatment from the primary health facility.

Conclusion: Generally, there are varying levels of delay of patients with tumours in reporting to primary health facilities and to referral centres. The major reasons cited for delay in reporting for health care were cost implications and tendency to attend to traditional healers.