Patient delay and associated factors among patients diagnosed with TB in Kajiado County

Abstract

Background: TB is among the leading causes of death from a single infectious agent worldwide. Globally, TB cases increased to 10.6 million in 2022, from 10.0 million in 2020. Africa had 2.5 million TB infections in 2016, making it the continent with the highest new cases globally. There was a 16.7 percent rise in DSTB cases in 2021. Kajiado was among nine counties that had reported high rise in case notification in 2022. Objective: Determine patient delay and associated factors among patients diagnosed with TB in Kajiado County. Methods: A cross-sectional research was carried out at five hospitals within Kajiado County from May to August 2021 on 354 TB patients who were 15 years of age or older. Data was collected using a pre-tested, semi-structured questionnaire that was entered into an Excel database. We cleaned the data in MS Excel and ran the analyses in Epi Info. Data were summarised for discrete variables using basic proportions and percentages, and for continuous variables using mean and standard deviations. We used the median time as our cut-off for patient delay calculations. A patient is considered to have delayed if they seek medical attention at a health facility 28 days (median time) or more after the onset of tuberculosis symptoms. Patients' delay was determined using logistic regression. Adjusted odds ratios were calculated with a 95% confidence interval, and we considered factors statistically significant in multivariate when p-values were less than or equal to 0.05. Results: A total of 354 (100%) patients with Tuberculosis participated in the study. The median time of the patient delay was 28 (+20) days. 46.3% of the study participants delayed to seek diagnosis. Lack of knowledge and lack of accessibility were the factors significantly associated with patient delay. Conclusion: The findings suggest that delay in seeking Tuberculosis diagnosis remains a challenge as a significant proportion of patients delayed in seeking diagnosis. Lack of knowledge and lack of accessibility to diagnostic sites were significantly associated with Tuberculosis patient delay. These factors for delay can be the subject of future interventions to reduce delay in diagnosis among patients with tuberculosis. Recommendations: The findings highlight the importance of relevant stakeholders to emphasize health education through community sensitization to ensure everyone is reached. The County Department of Health should strengthen referral and linkages between the community and health facilities. Enhance access through mobile outreach services. Further interventions that will improve knowledge and accessibility to TB care.