{"doi":"10.1093/trstmh/trac049","title":"A qualitative study of factors resulting in care delays for adults with meningitis in Zambia","abstract":"BACKGROUND: Meningitis causes significant mortality in regions with high comorbid HIV and TB. Improved outcomes are hindered by limited understanding of factors that delay adequate care. METHODS: In-depth interviews of patients admitted to the University Teaching Hospital with suspected meningitis, their caregivers, doctors and nurses were conducted. Patient/caregiver interviews explored meningitis understanding, treatment prior to admission and experiences since admission. Provider interviews addressed current and prior experiences with meningitis patients and hospital barriers to care. A conceptual framework based on the Three Delays Model identified factors that delayed care. RESULTS: Twenty-six patient/caregiver, eight doctor and eight nurse interviews occurred. Four delays were identified: in-home care; transportation to a health facility; clinic/first-level hospital care; and third-level hospital. Overcrowding and costly diagnostic testing delayed outpatient care; 23% of patients began with treatment inside the home due to prior negative experiences with biomedical care. Admission occurred after multiple clinic visits, where subsequent delays occurred during testing and treatment. CONCLUSIONS: Delays in care from home to hospital impair quality meningitis care in Zambia. Interventions to improve outcomes must address patient, community and health systems factors. Patient/caregiver education regarding signs of meningitis and indications for care-seeking are warranted to reduce treatment delays.","journal":"Transactions of the Royal Society of Tropical Medicine and Hygiene","year":2022,"id":268454,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9528,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":488093,"name":"Chiti Bwalya","orcid":"0000-0002-6110-0019","position":1,"is_corresponding":false},{"id":931208,"name":"Godfrey Muchanga","orcid":null,"position":2,"is_corresponding":false},{"id":931209,"name":"Mwangala Mwale","orcid":null,"position":3,"is_corresponding":false},{"id":930618,"name":"Nachizya Edith Namukanga","orcid":"0000-0002-9137-5427","position":4,"is_corresponding":false},{"id":42876,"name":"Gretchen L. Birbeck","orcid":"0000-0002-0735-3461","position":5,"is_corresponding":false},{"id":930619,"name":"Mashina Chomba","orcid":"0000-0001-9491-6025","position":6,"is_corresponding":false},{"id":931210,"name":"Anchindika Mugala-Mulenga","orcid":null,"position":7,"is_corresponding":false},{"id":930620,"name":"Michelle Kvalsund","orcid":"0000-0003-2519-4529","position":8,"is_corresponding":false},{"id":299399,"name":"Izukanji Sikazwe","orcid":"0000-0002-3898-2607","position":9,"is_corresponding":false},{"id":381409,"name":"Deanna Saylor","orcid":"0000-0002-9297-0244","position":10,"is_corresponding":false},{"id":427715,"name":"Peter J. Winch","orcid":"0000-0001-8569-5507","position":11,"is_corresponding":false},{"id":839827,"name":"Melissa A. Elafros","orcid":"0000-0002-4511-201X","position":0,"is_corresponding":true}],"reference_count":41,"raw_metadata":null,"created_at":"2026-07-19T00:27:14.088663Z","pmid":"35653707","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}