Factors associated with DELAY in diagnosis among tuberculosis patients in Hohoe Municipality, Ghana

BMC Public Health

Research Article

Patricia Akweongo¹  Eric Osei²  Fred Binka³ 

[1] Department of Epidemiology, School of Public Health, University of Ghana, Accra, Ghana;Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana;University of Health and Allied Sciences, Ho, Ghana;

关键词: Diagnosis;    Patient delay;    Tuberculosis;    Patients;    Hohoe-Ghana;    Healthcare service;   

DOI  :  10.1186/s12889-015-1922-z

 received in 2014-12-15, accepted in 2015-06-09,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAny delay in diagnosis and consequently treatment of TB patients not only increases the infectivity of the disease in the community, but may also lead to more advance disease state, which may result in more complications and expose patients to higher risk of death. The aim of this study was to assess delays in diagnosing new TB patients and the factors associated with these delays in Hohoe Municipality of Ghana.MethodsA cross sectional study was carried out among 73 new TB Patients, 15 years or older, registered between 1st June, 2013 and 31st May, 2014 in Hohoe Municipality. Questionnaires were administered to patients to evaluate factors related to delay by patients in seeking care, delays at healthcare facilities, and total diagnostic delay. Logistic regression was used to determine the factors associated with patient delay (>30 days), healthcare services delay (>15 days), and total delay (>45 days).ResultsThe median total delay was 104 days (inter-quartile range (IQR):17–191). The median patient delay was 59 days (IQR: 5–123), and the median healthcare services delay was 45 days (IQR: 38–128). Not medically insured (AOR = 6.12; 95 % CI: 1.26–29.88; P < 0.025) and perceived stigma (AOR = 5.30; 95 % CI: 1.33–21.18; P < 0.018) were risk factors associated with prolonged patient delay. Multiple healthcare contact following signs and symptoms (AOR = 10.26; 95 %CI: 2.95–35.72; P < 0.0001) was the only risk factor associated with prolonged healthcare services delay.ConclusionThere is a considerable delay in TB case detection mainly due to patients delay in seeking healthcare. The factors associated with patients’ delay include lack of medical insurance, perceived stigma, and making multiple healthcare encounters. Health system strengthening towards decentralizing TB diagnosis and management, raising public awareness about the disease, training of healthcare providers, and collaborating with non-formal healthcare providers may reduce long delays in the management of TB.

【 授权许可】

CC BY   
© Osei et al. 2015