Abstract

BackgroundDelayed presentation is a major problem contributing to the high burden and transmission of tuberculosis (TB) in developing countries. The delay may be due to patient delay if the patient visits health-facility for diagnosis after the onset of symptoms of more than 3 weeks or health system delay if the patient is not diagnosed and treated at the time of the first visit. Ethiopia, where no more than two-thirds of TB cases are detected is no exception. Therefore, the aim of this study was to assess delay in diagnosis of tuberculosis among patients taking anti-TB treatment in North Shoa Zone, Ethiopia.MethodsInstitution based cross-sectional study was conducted from 01 to 30 December 2017. All TB patients who took their treatment in the health facilities of the seven selected districts of North Shoa Zone were included. Data was entered into EPI INFO version 3.5.1 statistical software and transferred into SPSS version 20.0 for further analysis. Bivariate and multivariate analysis was used to identify associated factors for delayed TB diagnosis.ResultsOut of 170 tuberculosis patients included, 162 patients were studied with a response rate of 95.3%. The proportion of tuberculosis patients who had delayed diagnosis was 59.9%. The mean time of health-seeking after developing the symptom of tuberculosis was 7.6 weeks. Tuberculosis patients with extra pulmonary site involvements were about four times more likely to be delayed in seeking health services (OR: 4.00, 95% CI: 1.77–9.03) as compared to patients with pulmonary TB. New patients were about three times more likely to come lately for TB diagnosis (OR: 2.94, 95% CI: 1.26–6.84) as compared to patients who had previous-history of treatment. Patients who had no information about TB before they started TB treatment were also around three times to be delayed (OR: 3.37, 95% CI: 1.43–8.00) as compared to those who had the information.ConclusionsMore than 50% of TB patients reported in health-seeking relatively a longer time. Strengthening the health education activities for the community about tuberculosis and capacity building of the health care provider to increase suspicion of identifying tuberculosis and early diagnosis is crucial.

Highlights

  • Delayed presentation is a major problem contributing to the high burden and transmission of tuberculosis (TB) in developing countries

  • Ethiopia is still one among the 30 high burdens TB countries and The TB case detection rate is very low compared to the World Health Organization (WHO) target of detecting all infectious TB cases to reach annual decline of TB incidence by 4.5 to 5% [3,4,5,6]

  • Socio-demographic characteristics of study participants Out of 170 tuberculosis patients included in this study, 162 (95.3%) responded to participate in the study

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Summary

Introduction

Delayed presentation is a major problem contributing to the high burden and transmission of tuberculosis (TB) in developing countries. Tuberculosis (TB) remains a major global health problem It causes ill-health about 10 million people each year and is one of the top ten causes of death world-wide that kills three people within a minute [1,2,3,4]. Ethiopia is still one among the 30 high burdens TB countries and The TB case detection rate is very low compared to the World Health Organization (WHO) target of detecting all infectious TB cases to reach annual decline of TB incidence by 4.5 to 5% [3,4,5,6]. If not totally missed, delayed identification and diagnosis of TB cases plays a vital role in the transmission of the disease in the community in most developing countries.

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