NEWPORT INTERNATIONAL JOURNAL OF PUBLIC HEALTH AND PHARMACY (NIJPP)

Volume 3 Issue 3 2023

Assessment of Factors Influencing Tuberculosis Diagnostic and treatment delays among Patients at two Tertiary Hospitals in Ishaka, Bushenyi 

Tady Kerry Iyamuremye

School of Pharmacy, Kampala International University, Uganda

                                                                          ABSTRACT

Tuberculosis (TB) is an essential public health disease caused by Mycobacterium tuberculosis, a bacterium that depends on its human host to achieve its own airborne transmission and existence. The objective of this study is to determine the factors influencing tuberculosis diagnostic and treatment delay among patients at Ishaka Adventist Hospital and Kampala International University Teaching Hospital in Ishaka, Bushenyi. The study shows that rate of tuberculosis diagnostic and treatment delay was 76.0% that is 108 (70.1%) reported to have taken ≥ 3 weeks to seek for TB diagnosis (delayed TB diagnosis) and 42(27.3%) reported to have taken ≥ 1 week to initiate anti-TB treatment (delayed TB diagnosis). The study shows multivariate analysis of social demographic factors and knowledge attributes associated with tuberculosis diagnostic and treatment delay. According to results after multivariate model, the social demographic factors and knowledge attributes significantly associated with tuberculosis diagnostic and treatment delay were male gender (AOR= 5.97, 95%CI: 1.91-18.43, p = 0.002), knowing the TB symptoms (AOR= 11.9, 95%CI: 1.81-8.57, p =0.010), As well as knowing that regular use of a cloth or both hands to cover mouth and nose while coughing or sneezing can prevent TB (AOR= 5.29, 95%CI: 1.32-21.14, p = 0.018). The rate tuberculosis diagnostic and treatment delay were high with about three quarters of study population having TB diagnostic delay and less than a third of study population having TB treatment delay.

 Keywords: tuberculosis, diagnostic, treatment delays

INTRODUCTION

Tuberculosis (TB) is an essential public health disease caused by Mycobacterium tuberculosis, a bacterium that depends on its human host to achieve its own airborne transmission and existence [1]. It is one of the oldest human ailments and for more than50 years, measures have been in place to eliminate TB [7-9]. However, it is still incurable and is the second most common cause of infectious disease death worldwide, after HIV [10-12].The Lake Victoria area in Sub-Saharan Africa has one of the highest rates of tuberculosis [13]. According to the World Health Organization (WHO), 9.2 million people develop TB each year [7], with low-income countries accounting for 95% of all Tuberculosis patients around the world [14]. approximately 10 million new cases and 1.6 million deaths from tuberculosis, a major infectious cause of morbidity and mortality worldwide, were anticipated to have occurred in 2017 [15]. Uganda, one of the 22 nations with the highest TB burden, has a 67% treatment success rate, with 50% of TB patients also co-infected with HIV [16-19]. Approximately 95% of all TB-related deaths occur in low- and middle-income countries, where the disease burden is disproportionately concentrated [20]. Nearly 40% of TB cases were undetected globally by 2018 despite the fact that the majority of these deaths might be avoided with early diagnosis and treatment [21]. The TB problem is getting worse worldwide, but a notable issue is the number of cases that have gone untreated [22]; the delay between the onset of the disease and the time of diagnosis and the start of treatment could be the cause of this, among other things [23]. Delay in diagnosis may lead to illness progression, increased mortality, and community-wide disease spread [24]. Many definitions of delay have been used in studies of the diagnosis and treatment of tuberculosis (TB), but the two that are most frequently employed are delay due to patient variables and delay owing to healthcare system factors [25-29]. However, other studies have showed that the stigma attached to the disease could also hamper access to judicious health care [30].

REFERENCES

  1. Greenaway C, Menzies D, Fanning A, Grewal R, Yuan L, Fitzgerald JM. Delay in Diagnosis among Hospitalized Patients with Active Tuberculosis — Predictors and Outcomes. 1995; https://doi.org/10.1164/rccm.2107040
  2. Obeagu EI, Okoroiwu IL, Nwanjo HU, Nwosu DC. Evaluation of haematological parameters of tuberculosis patients in Umuahia. Eur. J. Pharm. Med. Res. 2019;6(7):693-9.
  3. Obeagu EI, Okoroiwu IL, Nwanjo HU, Nwosu DC. Evaluation of interferon-gamma, interleukin 6 and interleukin 10 in tuberculosis patients in Umuahia. Ann Clin Lab Res. 2019;7(2):307.
  4. Oloro OH, Oke TO, Obeagu EI. Evaluation of Coagulation Profile Patients With Pulmonary Tuberculosis and Human Immunodeficiency Virus in Owo, Ondo State, Nigeria. Madonna University journal of Medicine and Health Sciences ISSN: 2814-3035. 2022 Oct 16;2(3):110-9.
  5. Obeagu EI, Bot YS, Obeagu GU, Hassan AO. Factors contributing to treatment default by tuberculosis patients at art clinic: African perspective. Int. J. Curr. Res. Chem. Pharm. Sci. 2023;10(2):22-6.
  6. Obeagu E, Felix CE, MTB O, Chikodili UM, Nchekwubedi CS, Chinedum OK. Studies on some cytokines, CD4, iron status, hepcidin and some haematological parameters in pulmonary tuberculosis patients based on duration of treatment in Southeast, Nigeria. African Journal of Biological Sciences. 2021 Jan;3(1):146-56.
  7. Dara M, Dadu A, Kremer K, Zaleskis R, Kluge HHP. Epidemiology of tuberculosis in WHO European Region and public health response. 2013; 22. https://doi.org/10.1007/s00586-012-2339-3
  8. Chinedu K, Takim AE, Obeagu EI, Chinazor UD, Eloghosa O, Ojong OE, Odunze U. HIV and TB co-infection among patients who used Directly Observed Treatment Short-course centres in Yenagoa, Nigeria. IOSR J Pharm Biol Sci. 2017;12(4):70-5.
  9. Walter O, Anaebo QB, Obeagu EI, Okoroiwu IL. Evaluation of Activated Partial Thromboplastin Time and Prothrombin Time in HIV and TB Patients in Owerri Metropolis. Journal of Pharmaceutical Research International. 2022 Jan 21:29-34.
  10. Karim F, Islam A, Chowdhury AMR, Johansson E, Diwan VK. Gender differences in delays in diagnosis and treatment of tuberculosis. 2007; 329–334. https://doi.org/10.1093/heapol/czm026
  11. Olusola-Falae B, Obeagu EI, Odo M, Ochei KC, Solanke E, Idaboh T. Impact of community based tuberculosis care interventions on TB Case detection in Nigeria–What works and what does not. Int J Adv Multidiscip Res. 2016;3:30-9.
  12. Ofor IB, Obeagu EI, Ochei KC, Odo M. Evaluation of lipids and protein profiles in tuberculosis (Tb) patients on antituberculosis therapy in general hospital Umuguma, Owerri. Int. J. Curr. Res. Chem. Pharm. Sci. 2016;3(2):20-8.
  13. Kuo A, Teo J. Delayed diagnosis and treatment of pulmonary tuberculosis in high- burden countries : a systematic review protocol. 2019; 1–4. https://doi.org/10.1136/bmjopen- 2019-029807
  14. Sendagire I, Loeff MS, Van Der Mubiru M, Konde-lule J. Long Delays and Missed Opportunities in Diagnosing Smear-Positive Pulmonary Tuberculosis in Kampala , Uganda :ACross-SectionalStudy.2010;5(12),1–9. https://doi.org/10.1371/journal.pone.0014459
  15. Htun YM, Mi T, Khaing M, Yin Y, Myint Z, Aung ST, Hlaing TM. Delay in diagnosis and treatment among adult multidrug resistant tuberculosis patients in Yangon Regional Tuberculosis Center , Myanmar : a cross-sectional study. 2018; 4, 1–13.
  16. Mistry N, Rangan S, Dholakia Y, Lobo E, Shah S. Durations and Delays in Care Seeking , Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai , 2016; 1–17. https://doi.org/10.1371/journal.pone.0152287
  17. Odo M, Ochei KC, Obeagu EI, Barinaadaa A, Eteng UE, Ikpeme M, Bassey JO, Paul AO. TB Infection Control in TB/HIV Settings in Cross River State, Nigeria: Policy Vs Practice. Journal of Pharmaceutical Research International. 2020 Sep 18;32(22):101-9.
  18. Ifeanyi O, Uzoma O, OMTB O, Felix E, Stella E, Chinedum O. Evaluation of Some Cytokines, CD4, Hepcidin, Iron Profile and Some Haematological Parameters of Pulmonary Tuberculosis Patients Coinfected with HIV in Southeast of Nigeria. Journal of Pharmaceutical Research International. 2020 Aug 5;32(13):118-30.
  19. Ifeanyi OE, Okorie Hope M, Chinedum OK. Studies on Haematological parameters of patients with pulmonary tuberculosis before treatment with different ranges of CD4 levels in Southeast, Nigeria. Int. J. Curr. Res. Med. Sci. 2019;5(11):1-6.
  20. Huong NT, Vree M, Duong BD, Khanh VT, Loan VT, Co NV, Borgdorff MW, Cobelens Delays in the diagnosis and treatment of tuberculosis patients in Vietnam : a cross-sectional study. 2007;  8, 1–8. https://doi.org/10.1186/1471-2458-7-110
  21. Mercaldo R, Whalen C, Kakaire R, Nakkonde D, Handel A, Sekandi JN. Community drivers of tuberculosis diagnostic delay in Kampala , Uganda : a retrospective cohort study. 2021; 1–8.
  22. Muttamba W, Kyobe S, Komuhangi A, Lakony J, Buregyeya E, Mabumba E, Basaza RK. Delays in diagnosis and treatment of pulmonary tuberculosis in patients seeking care at a regional referral hospital, Uganda: a cross sectional study. BMC Research Notes, 2019; 1–5. https://doi.org/10.1186/s13104-019-4616-2.
  23. Okethwangu D, Birungi D, Biribawa C, Kwesiga B, Turyahabwe S, Ario AR. Multidrug-resistant tuberculosis outbreak associated with poor treatment adherence and delayed treatment : Arua District , 2019; 3, 1–10.
  24. Belay M, Bjune G, Ameni G, Abebe F. Diagnostic and treatment delay among Tuberculosis patients in Afar Region , Ethiopia : A cross-sectional study. BMC Public Health, 2012; 12(1), 1. https://doi.org/10.1186/1471-2458-12-369
  25. Ochei KC, Obeagu EI, Mbajiuka CS, Uzoije NU. Comparative assessment of five laboratory techniques in the diagnosis of pulmonary tuberculosis in Abuja. IOSR Journal of Dental and Medical Sciences. 2014;13:73-8.
  26. Odo M, Obeagu EI, Ochei KC, Nkombe E, Olusola-Falae B, Effa E, Affirima B. Intensified TB Case finding in PMTCT settings in Nigeria should be reconsidered. Int. J. Adv. Res. Biol. Sci. 2016;3(2):85-92.
  27. Adike CN, Agbakoba NR, Enweani IB, Obeagu EI, Ekelozie IS. Age-related Distribution of Mycoplasma pneumoniae in Respiratory Tract Infection in a Developing Country. Journal of Pharmaceutical Research International. 2021 Dec 13;33(55A):248-55.
  28. Ifeanyi OE. A review on iron homeostasis and anaemia in pulmonary tuberculosis. Int. J. Healthc. Med. Sci. 2018;4(5):84-9.
  29. Obeagu EI. An update on susceptibility of individuals to diseases based on ABO blood groups. Int. J. Curr. Res. Med. Sci. 2019;5(3):1-8.
  30. Storla DG, Yimer S, Bjune GA. A systematic review of delay in the diagnosis and treatment of tuberculosis. 2008; 9, 1–9. https://doi.org/10.1186/1471-2458-8-15
  31. Kyagulanyi E, Mirembe J, Nantaayi B, Nalukenge S, Mukasa D, Tamale J, Baluku The prevalence of concurrent pulmonary and extrapulmonary tuberculosis in Uganda: a retrospective study. Therapeutic Advances in Infectious Disease, 2022; 9, 20499361221107304.
  32. Alavi SM, Bakhtiyariniya P, Albagi Factors Associated With Delay in Diagnosis and Treatment of Pulmonary Tuberculosis. 2015; 8(3), 8–11. https://doi.org/10.5812/jjm.19238

Tady Kerry Iyamuremye (2023). Assessment of Factors Influencing Tuberculosis Diagnostic and treatment delays among Patients at two Tertiary Hospitals in Ishaka, Bushenyi. NEWPORT INTERNATIONAL JOURNAL OF PUBLIC HEALTH AND PHARMACY (NIJPP)3(3):50-60.

DOWNLOAD FULL TEXT PDF