MAGNITUDE OF PATIENT AND HEALTH SYSTEM DELAYS AND ASSOCIATED FACTORS AMONG TUBERCULOSIS PATIENTS IN GAMO ZONE PUBLIC HEALTH FACILITIES, SOUTHERN ETHIOPIA.

Abstract

ABSTRACT Background: Delayed tuberculosis (TB) diagnosis and treatment increase morbidity, mortality, expenditure, and transmission in the community. Early diagnosis and initiation of treatment is essential for effective TB control. Objective: The main objective of this study was to assess the magnitude and factors associated with patient and health system delay among tuberculosis patients in Gamo Zone, Southern Ethiopia, 2019. Methods: A cross-sectional study was conducted in Gamo Zone, Southern Ethiopia from February to April 2019. Fifteen health facilities of study area were selected randomly and 255 TB patients who were ≥18 years of age included. Data were collected using a questionnaire through face-to-face interview and analyzed using SPSS version 20.0. Delay was analyzed at two levels (patient and health system) using median as cut-off. Logistic regression analysis was performed to investigate factors of delays. A p-value of ≤ 0.05 at multivariate analysis was considered statistically significant. Results: The median (inter-quartile range) of patient and health system delays were 30(15-60) and 14(6-30) days, respectively. About 56.9% and 54.5% of patients had prolonged patients’ and health system delay, respectively. Patient whose first action were informal provider (adjusted odds ratio [AOR]: 2.24; 95% confidence interval [CI] 1.29, 3.86), presenting with weight loss (AOR: 2.53; 95%CI: 1.35, 4.74) and fatigue (AOR: