Delays in seeking treatment for symptomatic tuberculosis in Sabah, East Malaysia: factors for patient delay

Int J Tuberc Lung Dis. 2011 Sep;15(9):1231-8, i. doi: 10.5588/ijtld.10.0585.

Abstract

Setting: The state of Sabah contributes one third of the tuberculosis (TB) cases in Malaysia.

Objective: To collect information on factors that affect the time period from the onset of symptoms to first contact with health care providers, whether private or government.

Design: A cross-sectional study using a pre-tested questionnaire was conducted among 296 newly registered smear-positive TB patients in 10 districts in Sabah. Univariable and multivariable analyses were used to determine which risk factors were associated with patient delay (>30 days) and 'extreme' patient delay (>90 days).

Results: The percentage of patients who sought treatment after 30 and 90 days was respectively 51.8% (95%CI 45.7-57.9) and 23.5% (95%CI 18.6-29.0). The strongest factors associated with patient delay and 'extreme' patient delay was when the first choice for treatment was a non-government health facility and in 30-39-year-olds. 'Extreme' patient delay was also weakly associated, among other factors, with comorbidity and livestock ownership.

Conclusion: Delay and extreme delay in seeking treatment were more common when the usual first treatment choice was a non-government health facility. Continuous health education on TB aimed at raising awareness and correcting misconceptions is needed, particularly among those who use non-government facilities.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Animal Husbandry
  • Antitubercular Agents / therapeutic use*
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Health Education / methods
  • Humans
  • Malaysia
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Risk Factors
  • Surveys and Questionnaires
  • Time Factors
  • Tuberculosis / drug therapy*
  • Young Adult

Substances

  • Antitubercular Agents