ArticleRisk management and healthcare policy2020
Longer Delays in Diagnosis and Treatment of Pulmonary Tuberculosis in Pastoralist Setting, Eastern Ethiopia.
Article in Risk management and healthcare policy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Tuberculosis treatment delay and associated factors among pulmonary tuberculosis patients at public health facilities in Dale District and Yirgalem Town administration, Sidama Region, South Ethiopia.BMC infectious diseases · 2024Article
- Article
- Article
- Tuberculosis Knowledge and Delayed Health Care Seeking Among New Diagnosed Tuberculosis Patients in Primary Health Facilities in an Urban District, South Africa.Health services insights · 2021Article
- Impact of early chest radiography on delay in pulmonary tuberculosis case notification in Ethiopia.International journal of mycobacteriologyArticle
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aimed to assess the extent of patient, health system and total delays in diagnosis and treatment of pulmonary tuberculosis (TB) in Somali pastoralist setting, Ethiopia. PATIENTS AND
methodsA cross-sectional study among 444 confirmed new pulmonary TB patients aged ≥15 years in 5 TB care units was conducted between December 2017 and October 2018. Data were collected using a structured questionnaire and record review. We measured delays from symptom onset to provider visit, provider visit to diagnosis and diagnosis to treatment initiation. Delays were summarized using median days. Mann-Whitney and Kruskal-Wallis tests were used to compare delays between categories of explanatory variables. The Log-binomial regression model was used to reveal factors associated with health system delay ≥15 days, presented in adjusted prevalence ratio (APR) with 95% confidence interval (CI).
resultsThe median age of patients was 30 years, ranged from 15 to 82. The majority (62.4%) were male, and nearly half (46.4%) were pastoralists. The median patient, health system and total delays were 30 (19-48.5), 14 (4.5-29.5) and 50 (35-73.5) days, respectively. The median patient delay (35.5 days) and total delay (58.5 days) among pastoralists were substantially higher than the equivalent delays among non-pastoralists [p<0.001]. Of all, 3.8% of patients (16 of 18 were pastoralists) delayed longer than 6 months without initiating treatment. Factors associated with health system delay ≥15 days were mild symptoms [APR (95% CI) = 1.4 (1.1-1.7)], smear-negativity [APR (95% CI) = 1.2 (1.01-1.5)], first visit to health centers [APR (95% CI) = 1.6 (1.3-2.0)] and multiple provider contacts [APR (95% CI) = 5.8 (3.5-9.6)].
conclusionDelay in diagnosis and treatment remains a major challenge of tuberculosis control targets in pastoralist settings of Ethiopia. Efforts to expand services tailored to transhumance patterns and diagnostic capacity of primary healthcare units need to be prioritized.
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