Patient Delay and Associated Factors Among Pulmonary Tuberculosis Patients at Hadiya Zone Public Health Facilities in South Ethiopia, 2017
European Journal of Clinical and Biomedical Sciences
Volume 4, Issue 4, August 2018, Pages: 55-62
Received: Sep. 6, 2018;
Accepted: Oct. 4, 2018;
Published: Nov. 5, 2018
Views 1099 Downloads 125
Gedeyon Getahun, Hadiya Zone Health Department, Hossana, Ethiopia
Belay Erchafo, Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
Lakew Abebe Gebretsadik, Department of Health Education and Behavioral Science, Institute of Health, Faculity of Public Health, Jimma University, Jimma, Ethiopia
Mulugeta Chaka, Department of Health Education and Behavioral Science, Institute of Health, Faculity of Public Health, Jimma University, Jimma, Ethiopia
Early diagnosis and immediate initiation of treatment are essential for an effective TB control program. Delay in treatment is significant to both disease prognoses at the individual level and within the community. Patient delay and associated factors were assessed among pulmonary tuberculosis patients who are on treatment for the first two months at Hadiya zone public health facilities, south Ethiopia, 2017. Facility based cross sectional study triangulated by Qualitative study was employed on 340 Pulmonary Tuberculosis patients from March 10-April 20, 2017. Simple random sampling technique was used to select study health facility. Directly Observed Treatment Short-course User at the beginning of data collection was consecutively recruited in to the study until the intended 340 sample sizes were fulfilled. Data was collected from the participants using a pretested structured interviewer administered questionnaire. Multivariable binary Logistic regressions were used to identify independent predictors of Tuberculosis treatment delay for those variables which are candidate in bivariate analysis. A P-value < 0.05 at 95 % confidence intervals was considered statistical significance between dependent and predictors variables. Three hundred and Forty PTB patients with a response rate of 97.7% were enrolled from seven diagnostics and treatment centers. Among 340 Pulmonary Tuberculosis patients enrolled in the study, of which 49.1% experienced patient delay. The median patient delay was 31. Unable to read and write, Poor knowledge of Tuberculosis (AOR 3.96, 95% CI (2.286.86), self-treatment (AOR: 2, 95% CI (1.143.93), and financial constraint (AOR: 2.092, 95% CI (1.113.945) were the independent predictors of patient delay. Nearly half of the patients seek their first consultation after thirty days cut-off point. Unable to read and write, Poor knowledge of Tuberculosis, self-treatment and financial constraints were found to have association with patient delay. This may lead to continues existence of Tuberculosis cases which probably leads to the emergence of multiple drugs resistant. Implementation of well-designed information education, communication/behavioral change communication strategy for Tuberculosis control program to overcome high prevalence of patient delay.
Lakew Abebe Gebretsadik,
Patient Delay and Associated Factors Among Pulmonary Tuberculosis Patients at Hadiya Zone Public Health Facilities in South Ethiopia, 2017, European Journal of Clinical and Biomedical Sciences.
Vol. 4, No. 4,
2018, pp. 55-62.
WHO, Global Tuberculosis Report 2013. World Health Organization.
FMOH, (2012) Guidelines for clinical and programmatic management of TB, leprosy and TB/HIV in Ethiopia. FMOH, Addis Ababa.
Tsegaye D, A. E., Mesele T, Tadesse T, etal, Delay in Seeking Health Care and associated Factors among Pulmonary Tuberculosis patients in North Wollo Zone, Northeast Ethiopia: /institutionBased crossectional Study. iMedPub Journals 2016 7(3) 1-7.
WHO, Global Tuberculosis control.2010, WHO report.
WHO, Global Tuberculosis Report 2014a, Geneva: World Health Organization(2014a). WHO report.
WHO, World Health Organization (WHO) Global Tuberculosis Report, 2015, WHO report.
Abebe G, Deribew A, and Apers L, Knowledge, health seeking behavior and perceived stigma towards tuberculosis among tuberculosis suspects in a rural community in southwest Ethiopia. PLOS ONE 5(10).
FDREMOH, FDRE, Guideline for the national TB Leprosy Control Programme in Ethiopia Addis Ababa. Federal Ministry of Health Ethiopia, 2007.
Dye C, W. B., (2012) The population dynamics and control of tuberculosis. PubMedGoogle Scholar 328(5980).
Engeda EH, D. B., WoretaHK, KelkayMM, Ashenafie TD, eatal, (2016) Health Seeking Behaviour and Associated Factors among Pulmonary Tuberculosis Suspects in Lay Armachiho District, Northwest Ethiopia:Tuberc Res Treat.
Yimer S, B. G., Alen G,, Diagnostic and treatment delay among pulmonary tuberculosis patients in Ethiopia: a cross sectional study. BMC Infectious Diseases2005, 5(112).
Demissie M, L. B., Berhane Y, (2002) Patient and health service delay in the diagnosis of pulmonary tuberculosis in Ethiopia. BMC Public Health 22(23) 1-23.
Belay M, B. G., Ameni G, Abebe F, etal, (2012)Diagnostic and treatment delay among Tuberculosis patients in Afar Region, Ethiopia: A cross-sectional study. BMC Public Health, 12(369) PP1-23.
Gebeyehu E, A. M., Abeje G,, (2014) Factors Associated with Patient’s Delay in Tuberculosis Treatment in Bahir Dar City Administration, Northwest Ethiopia. BioMed Research International, Article ID: 701429.
Mesfin MM, T. T., Tareke IG, Kifle YT, Karen WH, Richard MJ, etal, (2005)Delays and care seeking behavior among tuberculosis patients in Tigray of northern Ethiopia., Ethiopian Journal of Health Development 19(12) 7-12.
Takarinda, H., AD, Nyathi B, Ngwenya M, Mutasa-ApolloT, SandyC, etal., Tuberculosis treatment delays and associated factors within the Zimbabwe national tuberculosis programme, 2016. MC Public Health 15(29) pp1-12.
Cambanis A, Y. M., Ramsay A, Squire SB, ArbideI, Cuevas L, etal, (2016) Rural poverty and delayed presentation to tuberculosis services in Ethiopia, Tropical Medicine and International Health21(1365-3156).
WHO, An in-depth analysis of the health-seeking behaviour of patients and health system responce in seven countries of eastern Meditrenian Region.2009WHO swizerland, Geneva. p. 1-48.
Liam CK, T. B., Delay in the diagnosis and treatment of pulmonary tuberculosis in patient attending a University Teaching Hospital.1997, NT J TUBERC LUNG DIS 1(326-332).
Salaniponi FM, H. A., Banda HJ,, Care seeking behaviour and diagnostic processes in patients with smear positive pulmonary tuberculosis in Malawi. INT J TUBERC LUNG DIS 1991 4(327-332).
Kansiime C, K. S., Levi M, Asiimwe BB, KatambaA, etal, Health Service Delay among Pulmonary Tuberculosis Patients Presenting to a National Referral Hospital, Kampala, Uganda: A Cross Sectional Study. The Pan African Medical Journal, 2013, 15(84).
Yimer S, G. Bjune, and Alene G, Diagnostic and treatment delay among pulmonary tuberculosis patients in Ethiopia: a cross sectional study.2005, BMC Infectious Diseases2005, 5(112) PP 1-8.
Hamza A, D. M., Gare S, Teshome G,, (2015) Delay in Tuberculosis Diagnosis amongTuberculosis Patients at the Three Hospitals: Asella, Robe and Abomsa of Arsi Zone, Oromia Regional State, Open Access Library journal(2).
Gele AA, B. G., AbebeF,, (2009) Pastoralism and delay in diagnosis of TB in Ethiopia. BMC Public Health 9(5).
Yimer S, Bjune G, and Alene G, Diagnostic and treatment delay among pulmonary tuberculosis patients in Ethiopia: a cross sectional study.2005, BMC Infect Dis, 5(112).