Determinants of late patient consultation at Ngog Mapubi District Hospital, Central Region of Cameroon

Abstract

Late consultation, defined as a delay of more than three days after the onset of the first symptoms, is a major public health issue. Globally, 53–55.8% of patients consult late, leading to avoidable complications and increased mortality. In sub-Saharan Africa, this rate ranges from 35% to over 50%, compromising the effectiveness of care. This study aimed to identify the factors associated with these delays in order to increase the rate of people attending Ngog Mapubi District Hospital at the onset of the first symptom. A cross-sectional analytical quantitative study was conducted from November 2022 to July 2023 at Ngog Mapubi District Hospital on a sample of 301 adult participants, recruited by convenience and interviewed using a semi-structured questionnaire. The consultation was considered late beyond three days. Data were analysed using RStudio; bivariate and multivariate logistic regressions were used to identify significant factors. Ethical approval for this study was obtained from the Ethics Committee of the University of Douala. The results showed that 196/301(65.12%) of patients consulted late. Multivariate analysis showed that late consultation was significantly associated with a transport cost of more than 5,000 CFA francs (AOR = 15.921; 95% CI: 4.266-2,065.833; p = 0.040), an annual cost of care of over 100,000 CFA francs (AOR = 15.921; 95% CI: 4.266-2,065.833; p = 0.040), the poor road conditions, whether moderate (AOR = 22.207; CI95%: 2.07-970.583; p = 0.047) or severe (AOR = 6.241; CI 95%: 1.589–35.479; p = 0.038), the absence of chest pain during sickness (AOR = 8.108; CI95%: 1.479–44.449; p = 0.016) and the use of self-medication (AOR = 5.554; CI95%: 2.038–15.134; p = 0.001). Late consultation at Ngog Mapubi District Hospital is a persistent challenge requiring targeted interventions. The results of this study highlight the importance of improving access to care and patient awareness of the importance of early consultation. Overcoming barriers to healthcare and enhancing patient awareness of the importance of early consultation are crucial for reducing delays and improving health outcomes in this community.