Factors Associated with Delay in Early Pulmonary Tuberculosis Case Detection Among Patients Attending Health Care in Kabale District.

Abstract

Introduction Among the communicable diseases, TB is the second leading cause of death worldwide, killing nearly two million people each year and in Uganda, TB remains a major public health problem. Thus, early TB case detection is essential for an effective TB control program. Methodology The cross sectional study design was used on 170 TB patients above 15 years of age in Kabale district who consecutively sampled. Descriptive statistics were used to determine the distribution of respondents on personal information and on the questions under each of the variables. Inferential statistics were determined using chi-square at bivariate analysis. Results Pretested questionnaires used in this research were found valid and quantitative data was used on early TB case detection and associated factors. Results revealed the following. TB patients with no education were less likely to be detected early with PTB than with education (OR = 0.01, CI = 0.00-0.29, p = 0. 043). Unemployed TB patients were less likely to be detected early with PTB than employed TB patients (OR = 0.04, CI = 0.0003-0.51, p = 0. 02). TB patients with an income of 300,000 or less were more associated with delayed early case detection Ugx (OR = 0.01, CI = 0.00-0.093, p = 0.006) than those with more than 300,000 Ugx. TB patients who did not receive social support were less likely to be detected early with PTB than those who have social support (OR = 0.09, CI = 0.02-0.53, p = 0.006). TB patients who were stigmatized were less likely to be diagnosed early with TB than those who were stigmatized (R = 0.08, CI 0.01-0.6, p = 0.0014). TB patients who did not know cough as a TB symptom were less likely to be diagnosed early with TB than those who did not know (R = 0.0, CI 0.0-0.04, p = 0.002). TB patients who never knew chest pain as a TB symptom were more likely to delay early TB case detection than their counterparts (OR = 0.04, CI = 0.0-0.3, p = 0.012).

TB patients who contacted either traditional healers or pharmacists were more likely to delay early TB detection than those who visited doctors/nurses during initial stages of the illness (p = 0.009). TB patients who agreed or were neutral on whether early TB case detection was necessary were less likely to access health facility for early TB case detection ((p = 0.037). Mild to moderate perception of illness was significantly associated with delayed TB case detection (p < 0.0001). TB patients who said that healthcare workers were always available whenever they visited the health facility were less likely to be detected late with TB than those who said sometimes they did not get health workers at the health facility (OR = 0.02, CI = 0.0-0.68, p = 0.03). Conclusions and recommendations Level of detection was low among TB patients with no education, no employment, low income, low social support, stigmatized ones, who lacked knowledge of cough and chest pain as TB symptoms, initially did not contact doctors/nurses, not aware of the necessity of TB case detection and those who failed to access health care workers.