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

Musa Mohammed Ali,Tirusew Maru Wondawek

doi:10.1186/s12889-019-7886-7

Musa Mohammed Ali, Tirusew Maru Wondawek

Open Access

https://doi.org/10.1186/s12889-019-7886-7

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Abstract

BackgroundIn low-income countries, delays in treatment seeking among tuberculosis patients contribute to easy transmission and high prevalence of tuberculosis.ObjectiveThe 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.MethodA 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.ResultsAmong 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).ConclusionNearly 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.

Highlights

In low-income countries, delays in treatment seeking among tuberculosis patients contribute to easy transmission and high prevalence of tuberculosis
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
Delay in treatment seeking and prevalence of smear positive TB This study revealed a substantial delay in treatment seeking behaviors among TB suspected patients in Adama town

Summary

Introduction

In low-income countries, delays in treatment seeking among tuberculosis patients contribute to easy transmission and high prevalence of tuberculosis. According to a global TB report in 2017, ten million people were infected with TB and 1.6 million died from the disease [1]. In 2014, Ethiopia identified 119,592 new TB cases and enrolled 597 drug-resistant cases [2]. Most of TB cases were identified in the productive age group [2]. According to report from Ministry of Health (MOH) hospital statistics indicates, TB is the third cause of death in Ethiopia [3]. Health indicators in 2009 revealed a 36.6% case detection rate in the Oromiya regional state with an estimated 48,310 smear-positive cases [3]. As most TB affected individuals belongs to the productive age group, Wondawek and Ali BMC Public Health (2019) 19:1527 this could affect socio-economic development of the country [3]

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