Factors associated with late presentation of suspected pulmonary tuberculosis cases to health facilities in Dagoretti District,

Abstract

Tuberculosis is a highly contagious disease accounting for a high number of deaths in the developing countries; it is caused by Mycobacterium tuberculosis. Tuberculosis control can be effectively achieved if individuals with the disease receive adequate and timely treatment. The duration in which a tuberculosis case remains infectious is of crucial importance with regard to the risk of exposure to the general population. The objective of this study was to investigate factors that contribute to late presentation of patients to TB management facilities. A cross sectional study was conducted on patients aged 18 years and above attending TB clinics in Dagoretti District, Nairobi Kenya. A total of 426 TB suspects were interviewed. Seeking medical care three weeks after onset of symptoms was considered as late presentation. Eight facilities were included in the study, which were those facilities with a well-functioning laboratory for performing acid fast microscopy. Out of the 426 tuberculosis suspects, 248 (58.2%) suspects had delayed in seeking medical care. After multivariate logistic regression, male gender (P=0,019, OR=1.6), level of education (Primary 5 to 8) (P=0.029, OR=1.26) and seeking over the counter drugs as a first resort after onset of symptoms (P= 0.01 OR=1.27), were found to be significantly associated with delay. The study concluded that male gender, having a level of education of primary 5 to 8 and the first place of medical care after onset of symptoms being over the counter drugs were all significantly associated with late presentation. Findings from this study should be used by policy makers in order to come up with ways to educate the public on the effects of delayed diagnosis on disease prognosis and course of treatment.