Patient Delay and Associated Factors Among Pulmonary Tuberculosis Patients at Hadiya Zone Public Health Facilities in South Ethiopia, 2017

Abstract

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.

Health care seeking behavior among presumptive tuberculosis patients in Ethiopia: a systematic review and meta-analysis

“…Ethiopia is one of the high TB, TB/HIV and MDR-TB burden countries [14] with an estimated prevalence of 108 per 100,000 population in smear-positive drug susceptible TB individuals [15]. In Ethiopia there are several studies that reported health facility related treatment initiation delay among TB patients [16][17][18][19][20][21]. However, few studies are conducted on the health seeking behavior from health facilities among presumptive TB patients.…”