Health System Delay among the Pulmonary Tuberculosis Patients Presenting in the DOTS Centers of Nepal

Laohasiriwong, Wongsa; Mahato, Roshan Kumar; Koju, Rajendra

doi:10.7860/jcdr/2016/18943.8003

Cited by 4 publications

(6 citation statements)

References 11 publications

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“…In agreement with previous studies, risk factors such as being a male, being employed, visiting health care facilities ≥3 times, and attending public hospitals (government hospitals) for the first time prior to diagnosis of TB were attributed to an increased PD [ 1 , 15 , 56 – 58 ]. Attending public hospitals was a risk factor for PD possibly because public hospitals are associated with prolonged waiting times, a high number of patients with diverse diseases, and lack of an adequate number of trained physicians.…”

Section: Discussionsupporting

confidence: 91%

“…Even though this region is not considered as having a high rate of incidence for TB, we found that the median of HSD in this region of Iran is higher than national value (52 vs. 42 days) [ 1 ]. Based on previous studies, there is a wide range of median HSD values, from 2 to 120 days, in industrialized and developing countries [ 15 , 17 , 23 , 61 – 63 ]. In this study, the median HSD was almost similar to studies in Malaysia (49 days), Vietnam (53 days), and New Zealand (49 days) [ 49 , 62 , 64 ]; lower than Mozambique (62 days), Pakistan (87 days), and Columbia (> 60 days) [ 1 , 39 , 52 , 65 ]; and higher than Taiwan (29 days), India (28 days), Nigeria (7 days), and Angola (7 days) [ 63 , 66 – 68 ].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that the factors of patient delay (PD) and healthcare system delay (HSD) in TB diagnosis and treatment increase the probability of TB transmission in the community as well as the mortality rate [ 10 , 13 , 14 ]. The issue of HSD of TB is a crucial challenge in both developed and developing countries [ 15 ], and HSD may be considered as a measure of the level of TB awareness and the efficiency of the country’s NTP [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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The identification of risk factors associated with patient and healthcare system delays in the treatment of tuberculosis in Tabriz, Iran

et al. 2018

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BackgroundTuberculosis (TB) is a serious health concern, particularly in developing countries. Various delays, such as patient delay (PD) and healthcare system delay (HSD) in the TB process, are exacerbating the disease burden and increasing the rates of transmission and mortality in various global communities. Therefore, the aim of this study is to identify risk factors associated with PD and HSD in TB patients in Tabriz, Iran.MethodsA cross-sectional study was conducted on 173 TB patients in Tabriz, Iran from 2012 to 2014. Patients were interviewed with a semi-structured questionnaire. Frequencies and percentages were reported for patient categories of sex, age, and education. The median and interquartile range (IQR) were reported for the time intervals of delays. Univariate and multivariate logistic regressions of delay in respect to socio-demographic and clinical variables were performed. Statistical significance was set at p < 0.05.ResultsThe median values for delays were 53 days for HSD (IQR = 73) and 13 days for PD (IQR = 57). Odds ratios (OR) associated with PD were: employed vs. unemployed (OR = 5.86, 95% CI: 1.59 to 21.64); public hospitals vs. private hospitals (OR = 2.64, 95% CI: 1.01 to 6.85); ≥ 3 vs. < 3 visits to health facilities before correct diagnosis (OR = 2.35, 95% CI: 1.08 to 5.11); and male vs. female (OR = 2.28, 95% CI: 1.29 to 4.39). The OR associated with HSD were: ≥ 3 vs. < 3 visits to health facilities before correct diagnosis (OR = 9.44, 95% CI: 4.50 to 19.82), without vs. with access to TB diagnostic services (OR = 3.56, 95% CI: 1.85 to 6.83), and misdiagnosis as cold or viral infection vs. not (OR = 2.62, 95% CI: 1.40 to 4.91).ConclusionsThe results provide for an important understanding of the risk factors associated with PD and HSD. One of the major recommendations is to provide more TB diagnostic knowledge and tools to primary health providers and correct diagnoses for patients during their initial visit to the health care facilities. The knowledge generated from this study will be helpful for prioritizing and developing strategies for minimizing delays, initiating early treatment to TB patients, and improving TB-related training programs and healthcare systems in Tabriz, Iran.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The identification of risk factors associated with patient and healthcare system delays in the treatment of tuberculosis in Tabriz, Iran

et al. 2018

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“…Such results were also found in a study by (Said et al, 2017). In contrast, both unemployment (Laohasiriwong et al, 2016;Dos Santos et al, 2005) and employment (Adenager et al, 2017) had been showed to be a significant contributing factor towards treatment delay.…”

Section: Ijphcssupporting

confidence: 63%

“…The use of CXR had been shown as insignificant factors, as opposed in other studies. The widely used of radiological investigations have been associated with reduced delay (Laohasiriwong et al, 2016;Ukwaja et al, 2013). In Melaka, all suspected TB patients must undergo CXR, unlike the issue of limited resources as found in other countries' literatures.…”

Section: Ijphcsmentioning

confidence: 99%

Factors Contributing to Treatment Delay Among Pulmonary Tuberculosis Patients in Melaka

Syafiq¹,

Juni

2018

IJPHCS

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Introduction: Early diagnosis of tuberculosis and prompt treatment are essentials components in controlling tuberculosis effectively. Delay in diagnosis will lead to delay in treatment and this may increase the infectivity in the community, worsen the disease state and increase the risk of mortality. Objectives:The aim of this study is to determine the proportion of treatment delay and its predictors among PTB patients in Melaka. Methodology:A cross-sectional study was conducted among PTB patients in Melaka from April until May 2018. A total of 184 eligible respondents were included in this study. They were interviewed by using a pre-tested and validated questionnaire adopted from World Health Organization (WHO). Data were analyzed by using SPSS version 23. Descriptive statistics and bivariate analysis was used to assess the significant contributing factors, and a multivariate logistic regression analysis to assess the relative impact of predictors of treatment delay. P-values of <0.05 were considered statistically significant.Results: Total of 122 (66.3%) out of 184 PTB patients had treatment delay. The median duration of treatment delay was 30 days. In multivariable analysis, co-morbidities (AOR 3.66, 95% CI: 1.702, 7.872), more than two health visits (AOR 5.938, 95% CI: 2.602, 13.552) and time to reach health facility of more than 15 minutes (AOR 3.352, 95% CI: 1.491, 7.537) were significant predictors of treatment delay. Conclusion:Based on the results, the proportion of treatment delay among PTB patients in Melaka was higher than found in other studies in Malaysia. The predictors were comorbidities, more health visits, and longer time taken to reach health facility.

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Health system delay and its associated factors among tuberculosis patients in Gamo Zone public health facilities, Southern Ethiopia: An institution-based cross-sectional study

Arja¹,

Bogale²,

Gebremedhin³

2022

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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Health System Delay among the Pulmonary Tuberculosis Patients Presenting in the DOTS Centers of Nepal

Cited by 4 publications

References 11 publications

The identification of risk factors associated with patient and healthcare system delays in the treatment of tuberculosis in Tabriz, Iran

The identification of risk factors associated with patient and healthcare system delays in the treatment of tuberculosis in Tabriz, Iran

Factors Contributing to Treatment Delay Among Pulmonary Tuberculosis Patients in Melaka

Health system delay and its associated factors among tuberculosis patients in Gamo Zone public health facilities, Southern Ethiopia: An institution-based cross-sectional study

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