Tubeculosis treatment delay and associated factors among pulmunorey tuberculosis patients at hadiya zone public health facility, snnpr 2017.

Abstract

Background: 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. No study was determining associated factors which influence of TB treatment delay in study area. Objective: the aim of the study is to assess the TB treatment Delay and associated factor among PTB patients who are on treatment for the first two months. Method: Facility based crossectional study triangulated by Qualitative study was employed on 340 PTB patients from March 10-April 20, 2017 in Hadiya zone public health facilities among PTB patients. Three woredas were selected from two urban and ten district woredas by Simple random sampling then after proporssional allocation of TB cases, Simple random sampling technique is used to select study health facility. DOTS User at the beginning of data collection was consecutively recruited in to the study until the intended 340 sample size 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 TB treatment delay for those variables which are candidate in bivariate analysis. A P-value < 0.05 at 95 % CI was considered statistical significance between dependent and predictors variables. Result: Among 340 PTB patients enrolled in the study, of which 49.1% experienced patient delay, 30% health system delay and 49.8% total delay. The median patient, health system and total delay were 31, 5, 35 days respectively. Unable to read and write, Poor knowledge of TB (AOR 3.96, 95% CI (2.28 6.86), self-treatment (AOR: 2, 95% CI (1.14 3.93), financial constraint (AOR: 2.092, 95% CI (1.11 3.945) were the independent predictors of patient delay. Visiting two or more health care providers (AOR: 3.40, 95% CI (1.910 – 6.07), prolonged referral (AOR: 3.004, 95% CI (1.59 5.67) were independent predictors of health system delay. Conclusion and recommendation: Nearly half of the total delay was contributed by patient delay.Unable to read and write, Poor knowledge of TB, self-treatment, financial constraints, prolonged referral, several visit of health care provider of two or more and ever used other drugs rather than Anti-TB drugs were found to have association with patient delay and health system delay. This may lead to continues existence of TB cases which probably leads to the emergence of MDRTB. The he median health system delay isn’t in the reasonable time with regard to situations on the ground. By this time supposed to manifest major pulmonary symptoms of TB. These patients were visiting two or more health care providers before diagnosis so that they could pose a risk to the health professionals as well unless otherwise properly managed.