Predictors of patient delay among pulmonary tuberculosis patients in Northeast Thailand.

Abstract

Pulmonary tuberculosis (PTB) is a major health problem in Thailand. Delay in getting treatment is an important factor which may worsen the disease and increase TB transmission. This study aimed to investigate the duration and predictors of patient delay among PTB patients in Northeast Thailand. A cross-sectional study was undertaken using a structured questionnaire in nine districts in Nakhon Ratchasima Province from July to September 2018. The duration between the first symptom onset and the first visit to a health facility was determined, with a period of greater than 30days defined as patient delay. Multiple logistic regression was used to identify predictors of the delay. 300 PTB patients participated in the survey, with patient delay identified in 39% of respondents. The median duration of the delay was 35days among participants overall. Through multivariate analysis, primary education, upper secondary education, previous TB knowledge, TB recognition, TB stigmatisation, weight loss, self-treatment, the number of visits with health providers and using a motorcycle to travel to the hospital were significant predictors of patient delay. Knowledge needs to be provided to people to increase their recognition and minimise stigmatisation of TB. Education about TB screening needs to be revised and delivered to health providers to increase and improve TB detection processes.