Determinants of delay in seeking health care among tuberculosis patients attending tuberculosis clinic at health service in jimma, Ethiopia: acase control study

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.