Delays in diagnosis and treatment among persons with new pulmonary tuberculosis in Mandalay District, Central Myanmar

Abstract

© 2020, Mahidol University - ASEAN Institute for Health Development. All rights reserved. Tuberculosis (TB) is a major public health problem, and Myanmar is one of the 20 TB high-burden countries worldwide. Delay in getting TB diagnosis and treatment will lead to a disastrous impact on the community. This study aims to assess the delays in treatment-seeking and associated factors among new pulmonary TB patients in Mandalay District, central Myanmar. A cross-sectional study was conducted in 13 TB at outpatient department (OPD) public health facility sites. Data were collected by face-to-face interviews and treatment-card reviews of new adult patients who registered and started treatment with the standard regimen from December 2015 to May 2016. Delay time was categorised by using median cut-off. Multiple logistic regression analysis was performed to assess the relative impact of predictor variables on delays in seeking treatment. The analysis revealed that being aged 35 years or older (AOR 1.85, 95% CI 1.05–3.28) and low level of knowledge (AOR 2.29, 95% CI 1.29–4.08) contributed to a delay in seeking diagnosis and treatment, while the total medical and transportation cost (AOR 0.45, 95% CI 0.25– 0.81) and no symptomatic (AOR 0.43, 95% CI 0.21–0.90) could increase the delay. Strengthening the health education activities for the community about TB and capacity building of health care providers to increase suspicion for identifying TB and early diagnosis are crucial.