Epidemiological Factors and Preventable Tuberculosis Transmission in a Hospital Setting in Malaysia

Abstract

Tuberculosis (TB) is a public health challenge in Malaysia. Delay in diagnosing and treating TB patients are associated with TB transmission. These treatment delays can be reduced by identifying and managing the contributing epidemiological factors. This study measured the magnitude of the delays in TB treatment in terms of patient delay, medical visit delay and treatment initiation delay. In addition, it aims to identify epidemiological factors contributing to these delays, the disease severity and positive sputum smear outcome. This is a cross sectional study of TB patients in a district hospital and the outcomes were computed in terms of percentage, survival curve, odds ratio and confidence interval. The patient delay, medical visit delay and initiation of treatment delay are 73%, 53% and 14% respectively. Patient delay is reduced to 50% after 28 days and is eliminated after 1120 days. Malay patients and patients without family history of TB have higher risk of experiencing all three delays. Non-Malays, males, patients with family history of TB and patients with TB contact have been related to higher risk of severe form of TB and positive smear. TB transmission can be reduced by managing the epidemiological factors identified in TB control measures.