Factors associated with treatment delay among newly diagnosed tuberculosis patients in Dessie city and surroundings, Northern Central Ethiopia: a cross-sectional study
Abstract Background Delayed treatment of tuberculosis (TB) cases increases the risk of death and rate of infection in the community. Early diagnosis and initiation of treatment is essential for effective TB control. The aim of this study was to assess length of delays and analyze predictors of treat...
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BMC
2018-07-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-018-5823-9 |
| _version_ | 1819030991286566912 |
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| author | Abdurahaman Seid Yeshi Metaferia |
| author_facet | Abdurahaman Seid Yeshi Metaferia |
| author_sort | Abdurahaman Seid |
| collection | DOAJ |
| description | Abstract Background Delayed treatment of tuberculosis (TB) cases increases the risk of death and rate of infection in the community. Early diagnosis and initiation of treatment is essential for effective TB control. The aim of this study was to assess length of delays and analyze predictors of treatment delay of newly diagnosed TB patients. Methods A cross-sectional study was conducted in Dessie city and surroundings from April1, 2016 to January 30, 2017. Fifteen health facilities of study area were selected randomly and 382 adult TB patients were included consecutively. Data were collected using a questionnaire and analyzed using SPSS version 20.0. Delay was analyzed at three levels (patient, health system and total) using median as cut-off. Logistic regression analysis was performed to investigate predictors of delays. A p-value of ≤0.05 at multivariate analysis was considered statistically significant. Results The median total, patients’ and health system’s delay was 36 [interquartile range (IQR): 24, 64], 30 (IQR: 15, 60) and 6 (IQR: 4, 8) days, respectively. About 41 and 47% of patients had prolonged patients’ and total delay, respectively. Practicing self-medication [adjusted odds ratio (AOR): 3.0; 95% CI: 1.3–5.6], having more than three family member in the household (AOR: 1.6; 95% CI: 1.02–2.50), older age (≥55 years) (AOR: 2.7; 95% CI: 1.27–5.83), being smear negative pulmonary tuberculosis (AOR: 2.3; 95% CI: 1.25–4.21) and extrapulmonary tuberculosis (AOR: 2.3; 95% CI: 1.28–4.07) were independent predictors of patients’ delay. Initial visit of general practitioners (AOR: 2.57; 95% CI: 1.43–4.63) and more than one health care visit (AOR: 2.12; 95% CI: 1.30–3.46) were independent predictors of health system’s delay. However, patients’ delay was shorter among widowed/divorced patients (AOR: 0.3; 95% CI: 0.1–0.8). Lower level of education [illiterate (AOR: 0.42; 95% CI: 0.20–0.92), grade 1–8 (AOR: 0.38; 95% CI: 0.18–0.81)] and diagnosis of TB using a chest X-ray (AOR, 0.32; 95% CI, 0.16–0.68) significantly reduce health system’s delay. Conclusion About half of TB patients delayed beyond 36 days before starting treatment, and the late patient health seeking behavior was the major contributor of total delay. Development and implementation of strategies aimed at addressing identified factors should be recognized in order to reduce TB treatment delay. Further well designed research is needed to explore additional risk factors of delayed treatment. |
| first_indexed | 2024-12-21T06:38:57Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-21T06:38:57Z |
| publishDate | 2018-07-01 |
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| spelling | doaj.art-fdc56643e05742a08ecd5427d1258b0f2022-12-21T19:12:48ZengBMCBMC Public Health1471-24582018-07-0118111310.1186/s12889-018-5823-9Factors associated with treatment delay among newly diagnosed tuberculosis patients in Dessie city and surroundings, Northern Central Ethiopia: a cross-sectional studyAbdurahaman Seid0Yeshi Metaferia1Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo UniversityDepartment of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo UniversityAbstract Background Delayed treatment of tuberculosis (TB) cases increases the risk of death and rate of infection in the community. Early diagnosis and initiation of treatment is essential for effective TB control. The aim of this study was to assess length of delays and analyze predictors of treatment delay of newly diagnosed TB patients. Methods A cross-sectional study was conducted in Dessie city and surroundings from April1, 2016 to January 30, 2017. Fifteen health facilities of study area were selected randomly and 382 adult TB patients were included consecutively. Data were collected using a questionnaire and analyzed using SPSS version 20.0. Delay was analyzed at three levels (patient, health system and total) using median as cut-off. Logistic regression analysis was performed to investigate predictors of delays. A p-value of ≤0.05 at multivariate analysis was considered statistically significant. Results The median total, patients’ and health system’s delay was 36 [interquartile range (IQR): 24, 64], 30 (IQR: 15, 60) and 6 (IQR: 4, 8) days, respectively. About 41 and 47% of patients had prolonged patients’ and total delay, respectively. Practicing self-medication [adjusted odds ratio (AOR): 3.0; 95% CI: 1.3–5.6], having more than three family member in the household (AOR: 1.6; 95% CI: 1.02–2.50), older age (≥55 years) (AOR: 2.7; 95% CI: 1.27–5.83), being smear negative pulmonary tuberculosis (AOR: 2.3; 95% CI: 1.25–4.21) and extrapulmonary tuberculosis (AOR: 2.3; 95% CI: 1.28–4.07) were independent predictors of patients’ delay. Initial visit of general practitioners (AOR: 2.57; 95% CI: 1.43–4.63) and more than one health care visit (AOR: 2.12; 95% CI: 1.30–3.46) were independent predictors of health system’s delay. However, patients’ delay was shorter among widowed/divorced patients (AOR: 0.3; 95% CI: 0.1–0.8). Lower level of education [illiterate (AOR: 0.42; 95% CI: 0.20–0.92), grade 1–8 (AOR: 0.38; 95% CI: 0.18–0.81)] and diagnosis of TB using a chest X-ray (AOR, 0.32; 95% CI, 0.16–0.68) significantly reduce health system’s delay. Conclusion About half of TB patients delayed beyond 36 days before starting treatment, and the late patient health seeking behavior was the major contributor of total delay. Development and implementation of strategies aimed at addressing identified factors should be recognized in order to reduce TB treatment delay. Further well designed research is needed to explore additional risk factors of delayed treatment.http://link.springer.com/article/10.1186/s12889-018-5823-9TuberculosisPatients’ delayHealth system’s delayDelay predictorsEthiopia |
| spellingShingle | Abdurahaman Seid Yeshi Metaferia Factors associated with treatment delay among newly diagnosed tuberculosis patients in Dessie city and surroundings, Northern Central Ethiopia: a cross-sectional study BMC Public Health Tuberculosis Patients’ delay Health system’s delay Delay predictors Ethiopia |
| title | Factors associated with treatment delay among newly diagnosed tuberculosis patients in Dessie city and surroundings, Northern Central Ethiopia: a cross-sectional study |
| title_full | Factors associated with treatment delay among newly diagnosed tuberculosis patients in Dessie city and surroundings, Northern Central Ethiopia: a cross-sectional study |
| title_fullStr | Factors associated with treatment delay among newly diagnosed tuberculosis patients in Dessie city and surroundings, Northern Central Ethiopia: a cross-sectional study |
| title_full_unstemmed | Factors associated with treatment delay among newly diagnosed tuberculosis patients in Dessie city and surroundings, Northern Central Ethiopia: a cross-sectional study |
| title_short | Factors associated with treatment delay among newly diagnosed tuberculosis patients in Dessie city and surroundings, Northern Central Ethiopia: a cross-sectional study |
| title_sort | factors associated with treatment delay among newly diagnosed tuberculosis patients in dessie city and surroundings northern central ethiopia a cross sectional study |
| topic | Tuberculosis Patients’ delay Health system’s delay Delay predictors Ethiopia |
| url | http://link.springer.com/article/10.1186/s12889-018-5823-9 |
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