TY - JOUR
T1 - Diagnostic and treatment delay among Tuberculosis patients in Afar Region, Ethiopia
T2 - A cross-sectional study
AU - Belay, Mulugeta
AU - Bjune, Gunnar
AU - Ameni, Gobena
AU - Abebe, Fekadu
N1 - Funding Information:
This study was supported by the Norwegian Programme for Development, Research and Education (NUFU) (Project number: NUFUPRO.2007\10198) as well as the Norwegian Research Council (Project No. 196397/S50). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Nurses Abubekir Endris at Asayta health center and Nuru Mekonnen at Dubti Hospital deserve our sincere gratitude for interviewing participants. We would like to acknowledge participants of the study for consenting to participate in the study.
PY - 2012
Y1 - 2012
N2 - Background: TB is a major public health problem globally and Ethiopia is 8th among the 22 high burden countries. Early detection and effective treatment are pre-requisites for a successful TB control programme. In this regard, early health seeking action from patients' side and prompt diagnosis as well as initiation of treatment from the health system's side are essential steps. The aim of this study was to assess delay in the diagnosis and treatment of TB in a predominantly pastoralist area in Ethiopia. Methods: On a cross-sectional study, two hundred sixteen TB patients who visited DOTS clinics of two health facilities in Afar Region were included consecutively. Time from onset of symptoms till first consultation of formal health providers (patients' delay) and time from first consultation till initiation of treatment (health systems delay) were analyzed. Results: The median patients' and health system's delay were 20 and 33.5 days, respectively. The median total delay was 70.5 days with a median treatment delay of 1 day. On multivariate logistic regression, self-treatment (aOR. 3.99, CI 1.50-10.59) and first visit to non-formal health providers (aOR. 6.18, CI 1.84-20.76) were observed to be independent predictors of patients' delay. On the other hand, having extra-pulmonary TB (aOR. 2.08, CI 1.08- 4.04), and a first visit to health posts/clinics (aOR. 19.70, CI 6.18-62.79), health centres (aOR. 4.83, CI 2.23-10.43) and private health facilities (aOR. 2.49, CI 1.07-5.84) were found to be independent predictors of health system's delay. Conclusions: There is a long delay in the diagnosis and initiation of treatment and this was mainly attributable to the health system. Health system strengthening towards improved diagnosis of TB could reduce the long health system's delay in the management of TB in the study area.
AB - Background: TB is a major public health problem globally and Ethiopia is 8th among the 22 high burden countries. Early detection and effective treatment are pre-requisites for a successful TB control programme. In this regard, early health seeking action from patients' side and prompt diagnosis as well as initiation of treatment from the health system's side are essential steps. The aim of this study was to assess delay in the diagnosis and treatment of TB in a predominantly pastoralist area in Ethiopia. Methods: On a cross-sectional study, two hundred sixteen TB patients who visited DOTS clinics of two health facilities in Afar Region were included consecutively. Time from onset of symptoms till first consultation of formal health providers (patients' delay) and time from first consultation till initiation of treatment (health systems delay) were analyzed. Results: The median patients' and health system's delay were 20 and 33.5 days, respectively. The median total delay was 70.5 days with a median treatment delay of 1 day. On multivariate logistic regression, self-treatment (aOR. 3.99, CI 1.50-10.59) and first visit to non-formal health providers (aOR. 6.18, CI 1.84-20.76) were observed to be independent predictors of patients' delay. On the other hand, having extra-pulmonary TB (aOR. 2.08, CI 1.08- 4.04), and a first visit to health posts/clinics (aOR. 19.70, CI 6.18-62.79), health centres (aOR. 4.83, CI 2.23-10.43) and private health facilities (aOR. 2.49, CI 1.07-5.84) were found to be independent predictors of health system's delay. Conclusions: There is a long delay in the diagnosis and initiation of treatment and this was mainly attributable to the health system. Health system strengthening towards improved diagnosis of TB could reduce the long health system's delay in the management of TB in the study area.
KW - Afar Region
KW - Ethiopia
KW - Health systems delay
KW - Patients delay
KW - Tuberculosis
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U2 - 10.1186/1471-2458-12-369
DO - 10.1186/1471-2458-12-369
M3 - Article
C2 - 22621312
AN - SCOPUS:84861334386
SN - 1471-2458
VL - 12
JO - BMC public health
JF - BMC public health
IS - 1
M1 - 369
ER -