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

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BMC Public Health

, 12:369

First Online: 23 May 2012Received: 31 December 2011Accepted: 01 May 2012DOI: 10.1186-1471-2458-12-369

Cite this article as: Belay, M., Bjune, G., Ameni, G. et al. BMC Public Health 2012 12: 369. doi:10.1186-1471-2458-12-369


BackgroundTB is a major public health problem globally and Ethiopia is 8 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.

MethodsOn 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.

ResultsThe 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.

ConclusionsThere 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.

KeywordsTuberculosis Patients’ delay Health system’s delay Afar Region Ethiopia AbbreviationsaORAdjusted Odds Ratio

CIConfidence Interval

DOTSDirectly Observed Treatment Short course

EPTBExtra-Pulmonary TB

IQRInterquartile Range

PTBPulmonary TB


WHOWorld Health Organization.

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Author: Mulugeta Belay - Gunnar Bjune - Gobena Ameni - Fekadu Abebe

Source: https://link.springer.com/

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