Prevalence and Factors Associated with Patient's Delay among New Smear–Positive Pulmonary Tuberculosis Patients in Phrae Province

Abstract

Tuberculosis remains one of the current potential health problems. Delay of
treatment has led to infection and increased incidence of the disease, thereby increasing
alarming rate of death. This was a cross-sectional analytical study of the duration and
prevalence of treatment delay among pulmonary tuberculosis patients in Phrae Province.
Factors associated with patient was also investigated. The subjects were 268 patients who
were selected by simple random sampling from all new smear-positive pulmonary
tuberculosis patients registered during the period between 1 October, 2012, and 30
September, 2014, at government health facilities in the province. The data were collected
using structured interviews and information from medical records and were summarized
using descriptive statistics. Simple and multiple logistic regression analyses were performed
to identify the factors associated with treatment delay.
The results showed that, 73.5% of the patients were female and their mean age
was 54.1 years. Almost half (47.8%; 95% CI=41.7-53.8) experienced a patient delay longer
than 30 days. For the multivariate analysis, the factors significantly associated with patient
delay were male gender (ORadj=1.11; 95% CI=0.51-2.41), age 50 years (ORadj=2.04; 95% CI=
1.09-3.83), low knowledge about tuberculosis (ORadj=11.50; 95% CI=3.97-33.26), seeking
healthcare at a pharmacy (ORadj=6.65; 95% CI=3.65-12.13), alcohol use (ORadj=2.36; 95% CI=
1.27-4.38), a monthly income ≤8,000 baht (ORadj=2.29; 95% CI=1.05-35.02), and distance to
health system facility≤8kms (ORadj=2.14; 95% CI=1.18-3.89).
The findings of this study indicate that, to reduce patient delay, there needs to
be a proactive network of community-based health education about tuberculosis and the
need for improvements in screening for the disease.