Factors associated with patient’s delay of treatment among new smear positive pulmonary tuberculosis patients in North-Eastern Thailand

Abstract

This study was cross-sectional analytical study aimed to identify the risk factors associated with patient’s delay of treatment among new-smear positive pulmonary tuberculosis (PTB) patients in North- Eastern Thailand. Data were collected from data set. The study was conduct in the tuberculosis clinics at five province hospitals in the North-Eastern Thailand (include Sisaket, Burirum, Mahasarakham, Nakhonratchasima and Khon kaen province) between 1 October, 2008, and 30 September, 2013. Descriptive statistics was applied to identify the value of: frequency, percentage, median and interquartiles rang (Q1 and Q3). A univariate analysis using the simple logistic regression was performed to identify the factors associated with treatment delay. A multiple logistic regression analysis was then performed to compute adjusted odds ratios (OR _adj) with 95% confidence intervals.

          The results show that, in a total of 1,366 new smear-positive PTB patients, 44.1 (95%CI = 41.4-46.7) experienced patient delay longer than 30 days. In the multivariate analysis, the factors significantly associated with patient delays were age ≤  50 years (OR_adj= 1.64, 95% CI= 1.29-2.09), unemployment or employment in agriculture (OR_adj= 1.36, 95% CI= 1.06-1.76), drinking alcohol (OR_adj= 1.39, 95% CI= 1.07-1.80), never seeking treatment in the government health system (OR_adj= 2.24, 95% CI= 1.76-2.85) never seeking treatment in traditional healer (OR_adj= 3.63, 95% CI= 2.51-5.25) and distance of home to hospital more than 10 kilometers (OR_adj= 1.35, 95% CI= 1.07-1.69).

          From the results of this study, health service for pulmonary tuberculosis patients need to be more proactive in terms of health education. Health services should build awareness and develop network partnerships between the public and private sectors for finding new patients in the community so that they can be treated as soon as possible in public health facilities.