Assessment of delayed tuberculosis diagnosis preceding diagnostic confirmation among tuberculosis patients attending isiolo county level four hospital, Kenya

Kunjok, David Majuch; Mwangi, Joseph; Mambo, Susan

doi:10.11604/pamj.2021.38.51.21508

Cited by 8 publications

(11 citation statements)

References 33 publications

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“…The investigation findings on factors influencing care-seeking delay and total delay indicate that symptoms such as cough and expectoration lasting for more than 1 week but less than 2 weeks, chest tightness, chest pain, low fever, night sweats, fatigue, loss of appetite, and weight loss were identified as protective factors. These results are consistent with previous studies conducted in Cambodia ( 38 ) and Kenya ( 39 ). The presence of severe symptoms, such as chest pain, fever, and weight loss, may prompt patients to seek medical treatment ( 40 ).…”

Section: Discussionsupporting

confidence: 93%

Analysis of care-seeking and diagnosis delay among pulmonary tuberculosis patients in Beijing, China

Zhang,

Ma,

Gao

et al. 2024

Front. Public Health

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BackgroundTuberculosis (TB) remains a significant public health challenge in China. Early detection and diagnosis of TB cases are crucial to interrupt disease transmission and prevent its progression. This study aims to describe the delay in seeking care and diagnosis among patients with pulmonary tuberculosis (PTB) and identify the influencing factors in two counties in Beijing.MethodsA retrospective analysis was carried out to investigate care-seeking and diagnosis delay in two counties in Beijing. Basic information of PTB patients from January 1 to December 31, 2021, was extracted from the Tuberculosis Information Management System of China (TBIMS), and all enrolled patients were interviewed via telephone using a standard questionnaire. Statistical description was performed using the median and interquartile range (IQR). Chi-square test and multivariate logistic regression model were used to analyze the influencing factors.Results537 patients were enrolled. The median duration of care-seeking and diagnosis delay was 11 (IQR: 5–26) days and 8 (IQR: 0–18) days, with 41.71 and 35.20% of patients experiencing delays (>14 days). The study found that being asymptomatic (OR = 2.791, 95%CI: 1.710–4.555) before seeking medical care and not attending work during treatment (OR = 2.990, 95%CI: 1.419–6.298) were identified as risk factors for care-seeking delay. Patients who were tracked (OR = 2.632, 95%CI: 1.062–6.521) and diagnosed at tuberculosis control and prevention institutions (OR = 1.843, 95%CI: 1.061–3.202) had higher odds of diagnostic delays. 44.69% of patients presented a total delay (>28 days), with a median duration of 25 (IQR: 13–39) days. A multivariate logistic regression analysis showed that healthy examination (OR = 0.136, 95%CI: 0.043–0.425) was a protective factor for total delay.ConclusionPublic interventions are necessary to improve the efficiency of PTB patients detection and treatment in Beijing. Medical services should focus on the target population and improve access to medical care to further reduce delays for PTB patients.

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Section: Discussionsupporting

confidence: 93%

Analysis of care-seeking and diagnosis delay among pulmonary tuberculosis patients in Beijing, China

Zhang,

Ma,

Gao

et al. 2024

Front. Public Health

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“…In our study, the median patient delay was 27 days. This finding is consistent with studies conducted in other parts of Ethiopia ( 13 , 20 , 30 , 35 ), Zimbabwe ( 31 ), Kenya ( 36 ), and Uganda ( 37 ), which revealed a median patient delay of 25–30 days. However, the median patient delay in our study was higher than that in studies in different areas of Ethiopia (17–21 days) ( 11 , 14 , 26 , 28 ) and Nigeria (8 days) ( 39 ).…”

Section: Discussionsupporting

confidence: 91%

Delay in seeking treatment and associated factors among pulmonary tuberculosis patients attending public health facilities in the Metekel zone, Benishangul Gumuz region, Western Ethiopia

Animut,

Godno,

Nigatu

et al. 2024

Front. Public Health

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BackgroundTuberculosis is a major global public health problem and a leading cause of morbidity and mortality in Ethiopia. TB prevention and control in low-income countries, such as Ethiopia, face significant challenges, including late detection and treatment initiation. A delay in the initiation of tuberculosis treatment increases the morbidity and mortality of patients and community transmission. Therefore, this study aimed to assess patient delay and associated factors among pulmonary tuberculosis patients attending public health facilities in the Metekel Zone, Benishangul Gumuz Region, Western Ethiopia.MethodsAn institution-based cross-sectional study was conducted from March to August 2020 among newly diagnosed pulmonary tuberculosis patients. All pulmonary tuberculosis patients (416) who came to all public health facilities of the Metekel zone for treatment during the period were included. Data were collected through face-to-face interviews using a structured and pretested questionnaire. A multivariable logistic regression was fitted to identify independent factors for delay in seeking treatment among PTB patients. Adjusted odds ratios with 95% CIs were determined, and variables with p values <0.05 were considered statistically significant.ResultsNearly three-fourths 302 (72.6, 95% CI: 68.5, 76.7) of the patients were delayed in seeking medical advice, with a median patient delay of 27 days (IQR: 21–31). Age of the patients [above 54 years (AOR = 2.65, 95% CI: 1.30, 5.40), 36–54 years (AOR = 1.86, 95% CI: 1.14,3.02)], family size of 5 members and above (AOR = 1.62, 95% CI: 1.10–3.14), travel time above 60 min (AOR = 3.65, 95% CI: 1.55, 8.60), history of visits to informal care providers (AOR = 1.74, 95% CI: 1.11, 3.14), and poor knowledge about PTB (AOR = 1.64, 95% CI: 1.04–2.44) were statistically significant factors associated with delays in seeking treatment among PTB patients.ConclusionMost pulmonary tuberculosis patients delay seeking medical advice for their illnesses. Delays in seeking treatment were associated with older age, large household size, longer travel time to reach the nearby health facility, visiting informal care providers, and poor knowledge about pulmonary tuberculosis. Hence, it is crucial to consider community screening programs, enhance public awareness, and ensure the accessibility of TB diagnostic and treatment services.

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“…The questionnaire was pre-tested and designed first in English and then translated into Amharic (native language). The questionnaire was adapted from both TB Care-II guidelines and previous literature [ 15 , 17 , 23 ]. Exit interviews were applied by trained enumerators.…”

Section: Methodsmentioning

confidence: 99%

Knowledge of symptoms and delays in diagnosis of extrapulmonary tuberculosis patients in North Shewa zone, Ethiopia

2022

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Introduction Delayed diagnosis contributes to the high burden and transmission of tuberculosis and extrapulmonary tuberculosis (EPTB) and continued to be a major public health problem in Ethiopia. Currently, there is insufficient knowledge on the contributing factors to diagnostic delay of EPTB patients in healthcare settings in Ethiopia, because of unique cultural and societal issues in this country. This study assessed patients’ knowledge of symptoms and contributing factors of delay in diagnosis of EPTB patients at selected public health facilities in North Shewa zone, Ethiopia. Methods An institutional-based study was conducted from March to April 2021. All recently registered EPTB patients were included. Logistic regression was performed to analyze the data. A significant association was declared at a p-value of < 0.05, and the results were presented with an adjusted odds ratio (AOR) and the corresponding 95% confidence interval (CI). Results In this study, only 15.5% of respondents knew EPTB symptoms. The median patient and healthcare system delay was 55 days. A patient delay of greater than 3 weeks and a health system delay of greater than 2 weeks were observed among 85.2% and 81% of patients, respectively. After the end of 5 weeks, 87.3% of EPTB patients had been diagnosed with the disease and the total median delay was 108.5 days. Living more than ten kilometers far from a health facility (AOR = 1.54; 95% CI = 1.11, 4.63), having never heard of EPTB disease (AOR = 5.52; 95% CI = 1.73, 17.56), and having ever taken antibiotics at the first health facility visit (AOR = 7.62; 95% CI = 2.26, 25.65) were associated with a total diagnostic delay of beyond 5 weeks. Conclusions The diagnostic delays of EPTB remain high. Both patient and health system delays equally contributed to the total diagnosis delay. Improving community awareness of EPTB and advancing diagnostic efficiencies of healthcare facilities could help reduce both delays.

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Assessment of delayed tuberculosis diagnosis preceding diagnostic confirmation among tuberculosis patients attending isiolo county level four hospital, Kenya

Cited by 8 publications

References 33 publications

Analysis of care-seeking and diagnosis delay among pulmonary tuberculosis patients in Beijing, China

Analysis of care-seeking and diagnosis delay among pulmonary tuberculosis patients in Beijing, China

Delay in seeking treatment and associated factors among pulmonary tuberculosis patients attending public health facilities in the Metekel zone, Benishangul Gumuz region, Western Ethiopia

Knowledge of symptoms and delays in diagnosis of extrapulmonary tuberculosis patients in North Shewa zone, Ethiopia

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