Delay in initiation of treatment of tuberculosis: A cross-sectional study from rural Wardha

Abstract

Background: India with 2.2 million incident cases annually contributed to around 25% of global incidence. Along with conventional indicators, magnitude of treatment delay would prove as a performance indicator for tuberculosis (TB) control in high TB burden countries like India. Objectives: The objectives of the study were to find out the magnitude of treatment delay among the TB patients, to describe the factors responsible for delay in treatment, if any, and to assess the knowledge of patients in a rural area about TB and directly observed treatment short course (DOTS). Study Design: Descriptive cross-sectional study was conducted among patients registered in the DOTS center at Mahatma Gandhi Institute of Medical Sciences Sewagram. Materials and Methods: Information of all 40 new sputum smear-positive TB patients registered at DOTS center between February and April 2015 was collected. Of these, thirty patients could be contacted successfully and were included in the study after obtaining consent. Data were entered in Microsoft Excel and analyzed using Epi Info software. Mean and median delay in terms of days were estimated. Mann–Whitney U-test was used to determine factors associated with treatment delay. Descriptive analysis using frequency and percentage was carried out to assess the knowledge regarding TB and DOTS. Results: Median delay was 35.5 days with diagnostic delay comprising 84% of it. Male patients and patients belonging to Below Poverty Line (BPL) families had significantly (P < 0.05) lesser median delay. Conclusions: Definite delay was seen in treatment initiation for TB with diagnostic delay contributing the most to the total delay.

Keywords

• Health-care quality indicator
• Mycobacterium
• program evaluation
• time-to-treatment