Abstract:
Background: Tuberculosis has been recognized as major public health problem and major
cause of death in both developed and developing countries. Low case detection rate is one of the
long standing key challenges of the TB control and prevention program in Ethiopia. An
effective TB control programme requires early diagnosis and immediate initiation of treatment.
Delay in diagnosis is serious because it not only adversely affects disease prognosis at the
individual level but also promotes transmission within the community and enhances TB
epidemics. Early detection, initiation of treatments and safeguarding cure should be the
highest priority.
Objective: the aim of this study was to determine factors that influence the delay in seeking
care among pulmonary tuberculosis patients attending TB clinics at Health service in Jimma
Town of Oromia region, Ethiopia.
Methods: Unmatched case-control study design was employed from March–May, 2017. A
total of 184 (92 cases and 92 controls) pulmonary TB patients were participated. The sample
was drawn from two hospitals and five health centers that provided DOTs service. Cases
were those delayed pulmonary TB patients whereas controls were those none delayed
pulmonary TB patients to seek care for TB treatment. Structured questionnaire was
administered to capture data from participants and for additional information review of DOTs
logbook and patient card were used. Odds ratio with 95 % confidence interval was computed
to assess the strength of association between dependent and independent variables.
Result: The median patient delay was 23 day (minimum 3 and maximum 240 days). After
adjusting for potential confounding factors significantly associated factors were identified.
Being older age above 46 years (AOR:3.58, CI:1.21, 10.56); having income less than 1000
ETB (AOR:2.5, CI:1.23, 5.11); self-medication (AOR:3.68, CI:1.58, 8.598); living place
>10km distance from health facility (AOR:3.027, CI:1.01, 9.11); illiteracy (AOR:2.79,
CI:1.29, 6.68) were determinant factors associated with delayed seeking health care and
having secondary level education (AOR:0.23, CI:0.08, 0.54) showed protective role.
Conclusion: Those factors mainly found to be attributed to delay in seeking health care
among pulmonary tuberculosis patients has been continued to be as major challenge and
public health concern. For most of the determinants intervention can be made at institutional
and community levels. The study provides a starting point for further examination of the
importance of these risk factors. As these factors can be prevented by health education efforts
and emphasis should be given to community based interventions.
