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Open Access Research article

Delay in Tuberculosis case detection in Pwani region, Tanzania. a cross sectional study

Esther S Ngadaya12*, Godfrey S Mfinanga2, Eliud R Wandwalo34 and Odd Morkve1

Author Affiliations

1 Centre for International Health, University of Bergen, Bergen, Norway

2 Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania

3 Ministry of Health and Social Welfare, National Tuberculosis and Leprosy Control Programme, (NTLP), P.O. Box 9083 Dar es Salaam, Tanzania

4 Management Sciences for Health, Dar es Salaam, Tanzania

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BMC Health Services Research 2009, 9:196  doi:10.1186/1472-6963-9-196

Published: 29 October 2009

Abstract

Background

Delay in Tuberculosis (TB) case detection may worsen the disease and increase TB transmission. It is also a challenge to the National TB and Leprosy control Program (NTLP).

Methods

We conducted a cross sectional study in four out of six districts in Pwani region to estimate the extent and factors responsible for delay in TB case detection in Pwani region. Delays were divided into patient, health facility and total delay.

Results

We enrolled a total of 226 smear positive TB patients. Out of 226 patient's results were available for 206. The majority (66.5%) of the patients were males. Mean age for males and females were 37.3 and 33.7 years respectively. Mean (SD) total delay was 125.5 (98.5) days (median 90). Out of 206 patients, 79 (38.35%) delayed to seek TB health care. Health facility delay was observed among 121 (58.7%) patients.

Risk factors for delay was poor knowledge that chest pain may be a TB symptom (OR = 2.9; 95%CI 1.20- 7.03) and the belief that TB is always associated with HIV/AIDS (OR = 2.7; 95%CI 1.39-5.23). Risk for delay was low among patients who first presented to a government health facility (OR = 0.3; 95%CI 0.12- 0.71) and those presenting with chest pain (OR = 0.2; 95%CI 0.10-0.61).

Conclusion

There is a considerable delay in TB case detection in Pwani mainly contributed by patients. Risk factors for delay include misconception about TB/HIV and poor knowledge of TB symptoms.