Patient delay in seeking TB diagnostic services

Abstract

Background: It has been documented that a major contributory factor to the high burden and transmission of tuberculosis (TB) is delayed presentation, which could be alarmingly prolonged from two months up to 12 months reportedly. This study explored the factors responsible for patient delay in seeking TB diagnostic services.

Methods: This was a descriptive cross-sectional study undertaken at selected TB centres with large annual turnover, using a pretested interviewer-administered questionnaire. The participants were TB patients accessing treatments at major TB centres, which included primary health centres, general hospitals, tertiary, and private facilities. Ultimately, 787 patients interviewed with complete records had their data analysed.

Results: A little less than two-thirds (63.3%) of the respondents were married, with about 7.8% of them having no form of formal education. About 54.8% of respondents reported first visiting a pharmacy or drug store after the onset of TB symptoms. The mean cough duration before medical consultation was 5.85 weeks, and 38.3% of respondents had a prolonged delay before seeking care. The identified predictors of patient delay in seeking TB diagnosis were older age, HIV seropositivity, private facility, and long facility distance.

Conclusion: The prevalence of prolonged delay in accessing TB diagnostic services is still generally high. Efforts must be made towards early case detection as many complications arise with late presentation. The delay can be reduced via active wareness creation, patient education, and improved engagement of private facilities in TB services to increase access to care.