Determinants of Treatment Delays among Pulmonary Tuberculosis Patients in Enugu Metropolis, South-East, Nigeria

Abstract

Introduction: Globally, the burden of Tuberculosis is escalating. Early diagnosis and prompt initiation of treatment are essential to achieve an effective tuberculosis control programme. Objective: To investigate the duration of delay for treatment and assess the determinants of treatment delays among pulmonary tuberculosis patients in Enugu metropolis, South-East, Nigeria. Methods: This cross sectional study was conducted among 219 pulmonary tuberculosis patients in six randomly selected DOTS centres in the three LGAs in Enugu metropolis. Data were analysed using SPSS version 17, and statistical significance of association between variables was assessed using Chi-square test at p 2 = 23.412, df = 8, p = 0.003), knowledge of the cause of TB (X2 = 42.322, df = 28, p = 0.040), TB symptoms experienced (X2 = 46.857, df = 20, p = 0.001), occupation (X2 = 34.217, df = 20, p = 0.025), and distance of the health facility from the respondents’ residence (X2 = 34.908, df = 8, p = 0.000). The positive predictors of delayed treatment, using logistic regression, were first presentation at: patent medicine dealer (OR 12.3 CI: 3.22 - 36.23), private hospital (OR 10.6 CI: 5.73 - 17.94), prayer house (OR 7.2 CI: 2.75 - 23.64), and traditional healer (OR 11.9 CI: 6.87 - 32.85). Conclusion: Majority of TB patients in this study did not present early to health facilities. The positive predictors of delayed presentation for appropriate PTB treatment were first presentations at inappropriate treatment centres. There is need to intensify public health awareness among potential TB patients on the associated risks of treatment delay to prevent transmission. Unskilled health care providers should refer suspected PTB patients promptly to facilitate their treatment.