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Decades of social and political unrest have contributed to the urbanization of the population of Peru with large-scale migration from rural Andean and Amazonian communities to overcrowded shantytowns around Lima. We administered a face-to-face survey questionnaire to 116 patients with suspected and proven tuberculosis (TB) in northern Lima to determine the extent to which the use of traditional therapies from indigenous regions persists and the impact of any such use on TB control. Sixty-three percent of participants reported some form of self-treatment prior to presentation to the National Tuberculosis Program; 52% of them used traditional remedies. Symptom duration was longer among self-remedy users than non-users (median = 25 versus 15 days; P = 0.07) and among those exclusively using western remedies rather than traditional remedies (median = 30 versus 15 days; P = 0.01). We thus found no evidence that use of traditional remedies has an appreciable effect on diagnostic delay in Lima.
Received February 21, 2005. Accepted for publication March 7, 2005.
Acknowledgments: We thank all participants in this study and Fanny García, Rosmery Gutierrez, Sonia Lopez, Carolay Salas, Eleana Sanchez, and Christian Solis for their crucial assistance with field work.
Financial support: Clarissa C. Oeser was supported by the Johns Hopkins/Weizmann Institute Research Exchange Program. Adrian R. Escombe, Carlton A. W. Evans, and David A. J. Moore were supported by Wellcome Trust Research Fellowships in Clinical Tropical Medicine.
* Address correspondence to David A. J. Moore, Universidad Peruana Cayetano Heredia, Avenida Honorio Delgado No. 430, Urb, Ingenieria, San Martin de Porras, Lima 31, Peru and Wellcome Centre for Clinical Tropical Medicine, Imperail College, London, United Kingdom. E-mail: daj.moore{at}imperial.ac.uk
Authors’ addresses: Clarissa C. Oeser, Adrian R. Escombe, and Robert H. Gilman, Asociación Benéfica PRISMA, Carlos Gonzales No. 251, Urb. Maranga, Lima 32, Peru, Telephone: 51-1-464-0221, Fax: 51-1-464-0781. Jon S. Friedland, Wellcome Centre for Clinical Tropical Medicine, Imperial College London (Hammersmith Campus), DuCane Road, London W12 0NN, United Kingdom, Telephone: 44-208-383-1943, Fax: 44-208-383-3394. Carlton A. W. Evans, Universidad Peruana Cayetano Heredia, Avenida Honorio Delgado No. 430, Urb, Ingenieria, San Martin de Porras, Lima 31, Peru, Telephone: 51-1-382-0929, Fax: 51-1-464-0781. David A. J. Moore, Universidad Peruana Cayetano Heredia, Avenida Honorio Delgado No. 430, Urb, Ingenieria, San Martin de Porras, Lima 31, Peru and Wellcome Centre for Clinical Tropical Medicine, Imperial College, London W12 0NN, United Kingdom, Telephone: 51-1-382-3398, Fax: 51-1-464-0781; E-mail: daj.moore{at}imperial.ac.uk.
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