Delay in treatment seeking and associated factors among suspected pulmonary tuberculosis patients in public health facilities of Adama town, eastern Ethiopia

BMC Public Health. 2019 Nov 14;19(1):1527. doi: 10.1186/s12889-019-7886-7.

Abstract

Background: In low-income countries, delays in treatment seeking among tuberculosis patients contribute to easy transmission and high prevalence of tuberculosis.

Objective: The aim of this study was to determine the magnitude of delays in treatment-seeking and risk factors among pulmonary tuberculosis suspected patients in health facilities located in Adama, Ethiopia.

Method: A health-facility based cross-sectional study was conducted at Adama from December 20, 2015, to March 1, 2016, among 598 tuberculosis suspected patients. Data was collected from all study participants on the same day of tuberculosis diagnosis using a structured questionnaire. Epi-Info 3.5.3 and Statistical package for the social sciences (SPSS) version 16.0 were used for data entry and analysis respectively. A bivariate and multivariable regression model was used to investigate the association between delay in seeking-treatment and various factors. Odds ratio with 95% CI and P-value < 0.05 were considered as cut off point to measure the strength and significance of the association.

Results: Among 598 pulmonary tuberculosis suspected patients, 79 (13.2%) were smear-positive. Among smear-positive participants, 61(77.2%) delayed seeking treatment and 275 (46%) patients delayed seeking treatment for > 30 days. The following factors were significantly associated with a delay in seeking treatment: female sex OR = 1.57, 95% CI (1.14, 2.18), low monthly income OR = 1.45, 95% CI (1.05, 2.01), lack of knowledge regarding tuberculosis OR = 1.67, 95% CI (1.13, 2.48), and cure rate of tuberculosis OR = 1.836, 95% CI (1.25, 2.69).

Conclusion: Nearly half of pulmonary tuberculosis suspected patients delayed seeking treatment in our study area. Female sex, low income, family size of five and greater, no knowledge about tuberculosis and cure rate were factors contributing to delay in treatment-seeking among suspected tuberculosis patients.

Keywords: Adama; Delay in treatment of tuberculosis; Ethiopia; Risk factors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cities
  • Cross-Sectional Studies
  • Delivery of Health Care
  • Developing Countries*
  • Ethiopia / epidemiology
  • Family Characteristics
  • Female
  • Health Facilities*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Income
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Acceptance of Health Care*
  • Poverty
  • Prevalence
  • Public Sector
  • Sex Factors
  • Surveys and Questionnaires
  • Time-to-Treatment*
  • Tuberculosis, Pulmonary* / diagnosis
  • Tuberculosis, Pulmonary* / epidemiology
  • Tuberculosis, Pulmonary* / therapy
  • Young Adult