Background: Delay in TB treatment is significant to both disease prognoses at the individual level and within the community. Even though studies conducted in TB treatment delay there is result inconsistencies due to differences in culture, environment and infrastructure. Objective: the aim of the study is to assess the tuberculosis treatment Delay and associated factor among pulmonary tuberculosis patients. Method: Facility based cross sectional study triangulated by Qualitative study was employed on 340 PTB patients in Hadiya zone public health facilities. Three woredas and health facilities were selected by Simple random sampling method. DOTS user at the beginning of data collection was consecutively recruited in to the study until the intended sample size was fulfilled. Multivariable binary Logistic regression was used. A P-value < 0.05 at 95 % CI was considered statistical significance between dependent and predictors variables. Result: Among 340 PTB patients enrolled in the study, of which 49.1% experienced patient delay, 30% health system delay and 49.8% total delay. Unable to read and write, Poor knowledge of TB (AOR 3.96, 95% CI (2.28   6.86), self-treatment (AOR: 2, 95% CI (1.14, 3.93), financial constraint (AOR: 2.092, 95% CI (1.11, 3.945) , Visiting two or more health care providers (AOR: 3.40, 95% CI (1.910 – 6.07), prolonged referral (AOR: 3.004, 95% CI (1.59, 5.67) were independent predictors of delay. Conclusion: Nearly half of the total delay was contributed by patient delay. Unable to read and write, Poor knowledge of TB, self-treatment, financial constraints, prolonged referral, several visit of health care provider of two or more and ever used other drugs rather than Anti-TB drugs were found to have association with patient delay and health system delay. Keywords: Tuberculosis treatment delay, PTB, patient delay and health system delay, Hadiya zone, Ethiopia.

Early diagnosis and immediate initiation of treatment are essential for an effective TB control program. Delay in treatment is significant to both disease prognoses at the individual level and within the community. Patient delay and associated factors were assessed among pulmonary tuberculosis patients who are on treatment for the first two months at Hadiya zone public health facilities, south Ethiopia, 2017. Facility based cross sectional study triangulated by Qualitative study was employed on 340 Pulmonary Tuberculosis patients from March 10-April 20, 2017. Simple random sampling technique was used to select study health facility. Directly Observed Treatment Short-course User at the beginning of data collection was consecutively recruited in to the study until the intended 340 sample sizes were fulfilled. Data was collected from the participants using a pretested structured interviewer administered questionnaire. Multivariable binary Logistic regressions were used to identify independent predictors of Tuberculosis treatment delay for those variables which are candidate in bivariate analysis. A P-value < 0.05 at 95 % confidence intervals was considered statistical significance between dependent and predictors variables. Three hundred and Forty PTB patients with a response rate of 97.7% were enrolled from seven diagnostics and treatment centers. Among 340 Pulmonary Tuberculosis patients enrolled in the study, of which 49.1% experienced patient delay. The median patient delay was 31. Unable to read and write (AOR 6, 95% CI (3.11 21.36), Poor knowledge of Tuberculosis (AOR 3.96, 95% CI (2.286.86), self-treatment (AOR: 2, 95% CI (1.143.93), and financial constraint (AOR: 2.092, 95% CI (1.113.945) were the independent predictors of patient delay. Nearly half of the patients seek their first consultation after thirty days cut-off point. Unable to read and write, Poor knowledge of Tuberculosis, self-treatment and financial constraints were found to have association with patient delay. This may lead to continues existence of Tuberculosis cases which probably leads to the emergence of multiple drugs resistant. Implementation of well-designed information education, communication/behavioral change communication strategy for Tuberculosis control program to overcome high prevalence of patient delay.

Background: Delay in TB treatment is significant to both disease prognoses at the individual level and within the community. Even though studies conducted in TB treatment delay there is result inconsistencies due to differences in culture, environment and infrastructure. Objective: The aim of the study was to assess health care system tuberculosis treatment Delay and associated factor among pulmonary tuberculosis patients. Method: Facility based cross sectional study triangulated by Qualitative data collection method. A total 340 PTB patients in Hadiya zone public health facilities included in the study. Health facilities were selected by Simple random sampling method from three woredas. DOTS user at the beginning of data collection was consecutively recruited in to the study until the intended sample size was fulfilled. Multivariable binary Logistic regression was used. A P-value < 0.05 at 95% CI was considered statistical significance between dependent and predictor variables. Result: 340 PTB patients participated in this the study. 30% of the PTB patients faced health system delay. Visiting two or more health care providers (AOR: 3.40, 95% CI (1.910, 6.07), every trying other drug than TB drug (AOR: 4.0, 95% CI (2.144, 7.465) and prolonged referral (AOR: 3.004, 95% CI (1.59, 5.67) were independent predictors of delay. Conclusion: Prolonged referral, several visit of health care providers of two or more and ever used other drugs rather than Anti-TB drugs were found to have association with patient delay and health system delay.