Delay in Seeking Health Care and associated Factors among Pulmonary Tuberculosis Patients in North Wollo Zone, Northeast Ethiopia: Institution Based Cross-sectional Study

Abstract

Background: Tuberculosis is one of the leading infectious diseases in Ethiopia. Emergence of MDR TB worsened the countries strategies towards the control of the diseases. Delay in seeking health care may worsen the disease, increase the risk of death and aggravate tuberculosis transmission in the community. Objective: This study was aimed at determining delay in seeking health care and analyzes factors influencing the delay from onset of symptoms of pulmonary tuberculosis until the presentation of modern health facilities. Methods: Institution based cross-sectional studies were conducted in randomly selected TB clinics, which deliver both diagnosis and treatment for TB in North Wollo health departments. Delay has analyzed from a period between onset of TB symptoms to first visit of any health provider (health seeking period). Respondents have interviewed on the same date of diagnosis using a semi-structured questionnaire. Binary logistic regression analysis applied to analyze the factors of delays. Results: Five hundred and twenty eight pulmonary TB patients aged 18 years and above enrolled in the study. Among these, 56.6% were males, 58.7% were married and 64% residing in rural areas. The median age was 33.5 (IQR=21) years. The median patient delay was 36 days and 62.3% of patients seek their first consultations after 30 days cut-off point. Long distance, rural residence, seeking treatment from traditional healers and poor knowledge about TB were associated factors that predict patient delay. Conclusion: A substantial proportion of long patients delay observed in seeking health care after 30 days cut-off point. Local authorities should collaborate, intensified awareness raising efforts to reduce high prevalence of patient delay in seeking health care.