Abstract

Delayed tuberculosis diagnosis and treatment increase morbidity, mortality, expenditure, and transmission in the community. Early diagnosis and initiation of treatment are essential for effective TB control. Therefore, the main objective of this study was to assess the magnitude and factors associated with patient delay among tuberculosis patients in Gamo Zone, Southern Ethiopia. A cross-sectional study was conducted in Gamo Zone, Southern Ethiopia from February to April 2019. Fifteen health facilities of the study area were selected randomly and 255 TB patients who were ≥18 years of age were included. Data were collected using a questionnaire through face-to-face interviews and analyzed using SPSS version 20.0. Patient delay was analyzed using the median as the cut-off value. Multivariable logistic regression analysis was fitted to identify factors associated with patient delay. A p-value of ≤ 0.05 with 95% CI was considered to declare a statistically significant association. The median (inter-quartile range) of the patient delay was 30 (15-60) days. About 56.9% of patients had prolonged patients' delay. Patient whose first contact were informal provider (adjusted odds ratio [AOR]: 2.24; 95% confidence interval [CI] 1.29, 3.86), presenting with weight loss (AOR: 2.53; 95%CI: 1.35, 4.74) and fatigue (AOR: 2.38; 95%CI: 1.36, 4.17) and body mass index (BMI) categories of underweight (AOR: 1.74; 95%CI: 1.01, 3.00) were independently associated with increased odds of patient delay. However, having good knowledge about TB (AOR: 0.44; 95% CI: 0.26, 0.76) significantly reduce patients' delay. In this study, a significant proportion of patients experienced more than the acceptable level for the patient delay. Knowledge about TB, the first action to illness, presenting symptoms, and BMI status were identified factors associated with patient delay. Hence, raising public awareness, regular training, and re-training of private and public healthcare providers, involving informal providers, and maintenance of a high index of suspicion for tuberculosis in the vulnerable population could reduce long delays in the management of TB.

Highlights

  • Effective TB control globally depends on substantial changes in TB prevention and care strategies in countries with a high burden, including Ethiopia

  • The main objective of this study was to assess the magnitude and factors associated with patient delay among tuberculosis patients in Gamo Zone, Southern Ethiopia

  • Tuberculosis has been recognized as a major global public health issue since 1993, and numerous global TB control measures have been developed and implemented, including Directly Observed Short-Course Treatment (DOTS), Stop TB, and End TB strategies [4,5,6]

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Summary

Introduction

Effective TB control globally depends on substantial changes in TB prevention and care strategies in countries with a high burden, including Ethiopia. Tuberculosis has been recognized as a major global public health issue since 1993, and numerous global TB control measures have been developed and implemented, including Directly Observed Short-Course Treatment (DOTS), Stop TB, and End TB strategies [4,5,6]. Successful diagnosis and treatment of TB saved an estimated 54 million lives between 2000 and 2017, and TB mortality has dropped by 33 percent since 1990. Given such progress and the fact that almost all cases can be treated, TB has remained one of the world’s major public health concerns [7].

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