Patients' Delay in Seeking Health Care for Tuberculosis Diagnosis in East Gojjam Zone, Northwest Ethiopia.

AbstractPatients' delay in seeking diagnosis is a major problem in the management of tuberculosis (TB). Relative to the burden of TB, there is lack of data on the magnitude of delays in seeking care and why patients fail to seek early care at health facilities in Ethiopia. A facility-based cross-sectional study was conducted from April to July 2013 in East Gojjam Zone, Amhara, Ethiopia, to assess patients' delays and associated factors in TB patients. Using simple random sampling, 605 (327 male and 278 female) participants were recruited. Of the total, 323 (53.4%) TB patients were delayed in seeking health care (median = 45 days; mean = 78.5 days). The following independent variables were associated with patient delays: age ≥ 45 years (adjusted odds ratio [AOR] = 8.74, 95% confidence interval [CI] = 4.71-16.23, P < 0.001); working as a farmer (AOR = 4.18, 95% CI = 1.44-12.11, P = 0.009); prior visit to holy water sites, traditional healers, and/or private drug shops (AOR = 69.11, 95% CI =13.91-343.29, P < 0.001; AOR = 14.74, 95% CI = 1.43-152.31, P = 0.024; AOR = 2.10, 95% CI = 1.22-3.59, P = 0.007, respectively); poor knowledge about TB (AOR = 2.79, 95% CI = 1.74-4.92, P = 0.006), and extrapulmonary TB (AOR = 14.69, 95% CI = 8.21-26.26, P < 0.001). Generally, patients' delay in seeking care at health facilities was high (53.4%). Most of TB patients getting treatment from holy water (95.3%; 101/106) and traditional healers (84.6%; 11/13) were delayed. Therefore, for early seeking in modern health care, a combination of interventions is required to encourage TB patients.