Mapping Delays in Diagnosing Haematologic Malignancies in Adults in Rivers State, Nigeria: Perspectives from Patients and Healthcare Providers
Paxman Dandyson Uku *
University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Christine Abaiayam Dangana
University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Emmanuel Wobo
University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Amarachi Faith Mbonu
University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Doreen Obugheni Arugu
University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Linda Anucha Dublin-Greene
Rivers State University Teaching Hospital, Port Harcourt, Nigeria.
Anuale Bright Piakorn
Rivers State University Teaching Hospital, Port Harcourt, Nigeria.
Thankgod Chukwudinma Bethel
Federal Medical Centre, Umuahia, Nigeria.
Chimankpam Edison Okechukwu Omeodu
Aviam Offshore Engineering Limited, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Introduction: In developing countries, patients tend to present late to healthcare facilities and this makes early diagnosis impossible. The experience among patients with haematologic malignancies in our part of the world is not different. The objective of this survey was to identify the various points that are associated with these delays and to suggest measures to improve in those areas.
Methodology: The was a mixed-methods survey involving adult haematologic cancer patients who presented to, and received care at the University of Port Harcourt Teaching Hospital and Rivers State University Teaching Hospital, both in Port Harcourt, Rivers State, and also healthcare providers who work in the healthcare facilities in the State. Data was collated using Google forms and information extracted was analyzed using SPSS version 26.
Results: A total of 110 healthcare workers and 30 adult patients with haematologic malignancies were surveyed in a space of 3 moths. Analyzed data were presented in tables, bar charts and pie charts.
Discussion: The average number of years from when patients first noticed symptoms to when they first presented to a healthcare facility was 3 years. Referral to a tertiary hospital and first contact with specialist was 2 years but time to diagnosis of HMs was in same year as referral. Financial difficulties as it pertains to cost of healthcare services at all levels of care, misdiagnosis of ailment, lack of diagnostic tools, absence of proper referral protocols, and poor interfacility communication are some of the identified points of failure.
Conclusion: This survey shows that there is an unacceptably long time between symptom onset to diagnosis of HM in this part of the world. This has been attributed to many reasons, however, financial difficulties on the part of the patients is central to the delay.
Keywords: Haematologic malignancies, delayed diagnosis, referral protocol, Port Harcourt, Rivers State