Determinants of health-seeking behaviours leading to total delay in tuberculosis treatment among adult patients in Kirinyaga County, Kenya
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20242857Keywords:
Health seeking behaviors, Tuberculosis, Anti-tuberculosis treatment, Patient delay, Pulmonary TBAbstract
Background: Total delay in tuberculosis (TB) treatment is a great challenge in public health, where it leads to more cases of morbidity and mortality. The study aimed to identify the determinants of health-seeking behaviors that lead to total delay in TB treatment.
Methods: Employed a mixed-method approach where qualitative and quantitative data were collected. Multistage sampling methods to identify the respondents.
Results: The findings revealed that the prevalence of total delay in TB treatment was 60.6%. 47% of the patients sought treatment after months of illness. 68% of patients committed to delay in seeking care due to lack of TB knowledge. 58% were diagnosed with TB on their first visit while 42% visited the health facility more than once before diagnosis. The patients experience the three levels of total delay; short delay (27%), moderate delay (28%), and long level (45%). Individual factors such as level of education, employment status, and comorbidities status were found to be associated with a total delay at a p value of 0.0028, 0.012, and <0.00, respectively.
Conclusions: The level of TB total delay was long among the patients where there was a delay in seeking care, diagnosis, and treatment. Factors such as level of education, employment status, and comorbidity status were found to be associated with health-seeking behaviors leading to total delay. Recommendations include; implementing TB programs, strengthening and promoting health education, health awareness campaigns, and prompt diagnosis and treatment of TB. Further research is necessary for additional factors and to assess intervention effectiveness.
References
Amatu M, Butto D, Muriuki D. Risk factors for Tuberculosis in Mwea West Sub-County, Kirinyaga County, Kenya. Meru University of Science and Technology Institutional Repository; 2017.
Latunji OO, Akinyemi OO. Factors influencing health-seeking behaviour among civil servants in Ibadan, Nigeria. Ann Ibadan Postgrad Med. 2018;16(1):52-60.
Ereso BM, Sagbakken M, Gradmann C, Yimer SA. Total delay and associated factors among tuberculosis patients in Jimma Zone, Southwest Ethiopia. PLoS One. 2023;18(2):e0281546.
Dantas DN, Enders BC, Oliveira DR, Vieira CE, Queiroz AA, Arcêncio RA. Factors associated with delay in seeking care by tuberculosis patients. Rev Brasil Enferm. 2018;71(suppl 1):646-51.
Maior MD, Guerra RL, Cailleaux-Cezar M, Golub JE, Conde MB. Time from symptom onset to the initiation of treatment of pulmonary tuberculosis in a city with a high incidence of the disease. J Brasil Pneumol. 2012;38:202-9.
Global tuberculosis control; Surveillance, Planning, Financing, Communicable diseases, 2013. Available at: https://iris.who.int/bitstream/handle/10665/ 91355/9789241564656_eng.pdf. Accessed on 30 July 2024.
WHO. Fact sheet: Global tuberculosis report, 2017. Available at: https://www.who.int/publications/i/ item/9789241565516. Accessed on 30 July 2024.
WHO. Fact sheet: Global tuberculosis report, 2020. Global Tuberculosis Programme. Available at: https://apps.who.int/iris/bitstream/handle/10665/336069/9789240013131- eng.pdf. Accessed on 30 July 2024.
WHO. Fact sheet: Global Tuberculosis Report 2015-Executive Summary, 2015. World Health Organization. Available at: https://iris.who.int/bitstream/handle/10665/191102/9789241565059_eng.pdf. Accessed on 30 July 2024.
WHO. Fact sheet: Global tuberculosis report, 2014. World Health Organization. Available at: https://iris.who.int/bitstream/handle/10665/137094/9789241564809_eng.pdf. Accessed on 30 July 2024.
Ehsanul Huq KA, Moriyama M, Zaman K, Chisti MJ, Long J, Islam A, et al. Health seeking behaviour and delayed management of tuberculosis patients in rural Bangladesh. BMC Infect Dis. 2018;18:1-9.
Alema HB, Hailemariam SA, Misgina KH, Weldu MG, Gebregergis YS, Mekonen GK, et al. Health care seeking delay among pulmonary tuberculosis patients in North West zone of Tigrai region, north Ethiopia. BMC Infect Dis. 2019;19:1-8.
Nairobi City Council. Fact sheet: World TB Day: Yes! We can End TB. Nairobi, 2023. Available at: https://nairobi.go.ke/world-tb-day-yes-we-can-end-tb/. Accessed on 30 July 2024.
Ministry of Health. Fact sheet: The First Kenya Tuberculosis Patient Cost Survey, 2017. The National Tuberculosis, Leprosy and Lung Disease Program. Available at: https://www.chskenya.org/ wp-content/uploads/2018/07/TB-Patient-Cost-Survey-2018.pdf. Accessed on 30 July 2024.
DHIS 2. Fact sheet: District Health Information System. Ministry of Health; Kirinyaga County; 2019.
The Division of National Tuberculosis. Fact sheet: Integrated guideline for tuberculosis, leprosy and lung disease. 2021. Available at: https://chskenya.org/wp-content/uploads/2022/04/INTEGRATED-GUIDELINE-FOR-TUBERCULOSIS-LEPROSY-AND-LUNG-DISEASE-2021.pdf. Accessed on 30 July 2024.
Asres M, Gedefaw M, Kahsay A, Weldu Y. Patients’ delay in seeking health care for tuberculosis diagnosis in East Gojjam zone, Northwest Ethiopia. Am J Trop Med Hyg. 2017;96(5):1071.
Jiang Y, Luo L, Gui M, Liu L, Lin Y, Deng G, et al. Duration and determinants of delayed diagnosis with tuberculosis in Shenzhen, China: a cross-sectional study. Risk Manage Healthcare Policy. 2022:1473-81.
Arja A, Godana W, Hassen H, Bogale B. Patient delay and associated factors among tuberculosis patients in Gamo zone public health facilities, Southern Ethiopia: An institution-based cross-sectional study. PloS One. 2021;16(7):e0255327.
Kunjok DM, Mwangi JG, Mambo S, Wanyoike S. Assessment of delayed tuberculosis diagnosis preceding diagnostic confirmation among tuberculosis patients attending Isiolo County level four hospital, Kenya. Pan Afr Med J. 2021;38(1).
Okwara FN, Oyore JP, Were FN, Gwer S. Correlates of isoniazid preventive therapy failure in child household contacts with infectious tuberculosis in high burden settings in Nairobi, Kenya- a cohort study. BMC Infect Dis. 2017;17:1-1.
