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BMC Public Health
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Diagnostic and treatment delay among Tuberculosis patients in Afar Region, Ethiopia: A cross-sectional study

Authors: Mulugeta Belay, Gunnar Bjune, Gobena Ameni, Fekadu Abebe

Published in: BMC Public Health | Issue 1/2012

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Abstract

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 system’s 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.
Literature
1.
World Health Organization: Global tuberculosis control. 2011, Geneva: WHO
2.
World Health Organization: Communicable disease epidemiological profile for Horn of Africa. 2007, Geneva: WHO
3.
World Health Organization: Global tuberculosis control surveillance, planning, financing. 2008, Geneva: WHO
4.
5.
Storla DG, Yimer S, Bjune GA: A systematic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health. 2008, 8 (1): 15-10.1186/1471-2458-8-15.CrossRefPubMedPubMedCentral
6.
Abdi G, Bjune G, Fekadu A: Pastoralism and delay in diagnosis of TB in Ethiopia. BMC Public Health. 2009, 9: 5-10.1186/1471-2458-9-5.CrossRef
7.
Demissie M, Lindtjorn B, Berhane Y: Patient and health service delay in the diagnosis of pulmonary tuberculosis in Ethiopia. BMC Public Health. 2002, 2 (1): 23-10.1186/1471-2458-2-23.CrossRefPubMedPubMedCentral
8.
9.
Population Census Commission: Summary and statistical report of the 2007 Population and Housing Census results. 2008, Addis Ababa: Population Census Commission
10.
Afar Bureau of Finance and Economic Development: Regional Atlas of Afar Region. 2006, Semera
11.
Federal Ministry of Health: Health and health-related indicators. 2007, Addis Ababa
12.
Federal Ministry of Health: Tuberculosis, Leprosy and TB/HIV Prevention and Control Programme. 2008, Addis Ababa
13.
Wandwalo ER, Morkve O: Delay in tuberculosis case-finding and treatment in Mwanza, Tanzania. Int J Tuberc Lung Dis. 2000, 4 (2): 133-138.PubMed
14.
Pirkis JE, Speed BR, Yung AP, Dunt DR, Maclntyre CR, Plant AJ: Time to initiation of anti-tuberculosis treatment. Tuber Lung Dis. 1996, 77 (5): 401-406. 10.1016/S0962-8479(96)90111-2.CrossRefPubMed
15.
Yimer S, Bjune G, Alene G: Diagnostic and treatment delay among pulmonary tuberculosis patients in Ethiopia: a cross sectional study. BMC Infect Dis. 2005, 5 (1): 112-10.1186/1471-2334-5-112.CrossRefPubMedPubMedCentral
16.
Bassili A, Seita A, Baghdadi S, AlAbsi A, Abdilai I, Agboatwalla M, Maamari F, Nasehi M, Nasir H, Soliman S, Enarson DA: Diagnostic and treatment delay in tuberculosis in 7 countries of the Eastern Mediterranean Region. Infect Dis Clin Prac. 2008, 16 (1): 23-10.1097/IPC.0b013c31815d8d61.CrossRef
17.
Cambanis A, Yassin MA, Ramsay A, Arbide I, Bertel Squire S, Cuevas LE: Rural poverty and delayed presentation to tuberculosis services in Ethiopia. Trop Med Int Health. 2005, 10 (4): 330-335. 10.1111/j.1365-3156.2005.01393.x.CrossRefPubMed
18.
Mengiste M, James N, John W, Amanuel G, Richard M: Delayed consultation among pulmonary tuberculosis patients: a cross sectional study of 10 DOTS districts of Ethiopia. BMC Public Health. 2009, 9: 53-10.1186/1471-2458-9-53.CrossRef
19.
Legesse M, Ameni G, Mamo G, Medhin G, Shawel D, Bjune G, Abebe F: Knowledge and perception of pulmonary tuberculosis in pastoral communities in the middle and Lower Awash Valley of Afar region, Ethiopia. BMC Public Health. 2010, 10 (1): 187-10.1186/1471-2458-10-187.CrossRefPubMedPubMedCentral
20.
21.
Rojpibulstit M, Kanjanakiritamrong J, Chongsuvivatwong V: Patient and health system delays in the diagnosis of tuberculosis in Southern Thailand after health care reform. Int J Tuberc Lung Dis. 2006, 10 (4): 422-428.PubMed
22.
Liefooghe R, Baliddawa JB, Kipruto EM, Vermeire C, De Munynck AO: From their own perspective: A Kenyan community's perception of tuberculosis. Trop Med Int Health. 1997, 2 (8): 809-821. 10.1046/j.1365-3156.1997.d01-380.x.CrossRefPubMed
23.
Farah MG, Rygh JH, Steen TW, Selmer R, Heldal E, Bjune G: Patient and health care system delays in the start of tuberculosis treatment in Norway. BMC Infect Dis. 2006, 6 (1): 33-10.1186/1471-2334-6-33.CrossRefPubMedPubMedCentral
24.
Lewis KE, Stephens C, Shahidi MM, Packe G: Delay in starting treatment for tuberculosis in east London. Commun Dis Public Health. 2003, 6 (2): 133-138.PubMed
25.
Steen TW, Mazonde GN: Pulmonary tuberculosis in Kweneng District, Botswana: delays in diagnosis in 212 smear-positive patients. Int J Tuberc Lung Dis. 1998, 2 (8): 627-634.PubMed
26.
Girma A, H/Mariam D, Deribe K: Quality of tuberculosis care in six health facilities of Afar Region, Ethiopia. Ethiop Med J. 2010, 48 (3): 195-202.PubMed
27.
Rajeswari R, Chandrasekaran V, Suhadev M, Sivasubramaniam S, Sudha G, Renu G: Factors associated with patient and health system delays in the diagnosis of tuberculosis in South India. Int J Tuberc Lung Dis. 2002, 6 (9): 789-795.PubMed
28.
Lawn SD, Afful B, Acheampong JW: Pulmonary tuberculosis: diagnostic delay in Ghanaian adults. Int J Tuberc Lung Dis. 1998, 2 (8): 635-640.PubMed
29.
Odusanya OO, Babafemi JO: Patterns of delays amongst pulmonary tuberculosis patients in Lagos, Nigeria. BMC Public Health. 2004, 4 (1): 18-10.1186/1471-2458-4-18.CrossRefPubMedPubMedCentral
Metadata
Title
Diagnostic and treatment delay among Tuberculosis patients in Afar Region, Ethiopia: A cross-sectional study
Authors
Mulugeta Belay
Gunnar Bjune
Gobena Ameni
Fekadu Abebe
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-369

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