KUMJ | VOL. 16 | NO. 1 | ISSUE 61 | JAN.-MARCH, 2018
Diagnostic and Treatment Delays among the Tuberculosis Patients in the Urban Area of Western Nepal
KC A, KC R, Sharma I
Abstract: ABSTRACT
Background
Diagnosis and treatment of tuberculosis is vital for health system to identify, treat
patients as early as possible and to reduce frequency of new cases of a disease
among the contacts of known cases.
Objective
To determine the diagnostic and treatment delay in the urban population of the
western, Nepal and factors associated to it.
Method
An institutional based cross-sectional study was conducted in urban area of Western
Nepal. Category I 142 TB patients aged over 15 years visiting DOTs centre during
period of three months were included in study. Interview schedule was designed to
elicit information on socio- demographic characteristics and history of symptoms.
Diagnostic and treatment delay was calculated, chi square test was applied to find
associations and non – parametric tests (Mann Whitney U test and Kruskal Wallis H
test) for evaluating group differences.
Result
Out of 142 TB clients, mean age was 38.12 years. Majority (58%) were males. Around
44% belong to upper, 30% middle and 26% lower economic class. Study showed
median diagnostic delay 34 days (Q
3
=68 Days, Q
=19 Days), treatment delay less than
a day (Q
3
=1 Day, Q
1
1
=0 Day) and total delay 33.50 days (Q
3
=71 Days, Q
=19 Days).
Smear positive patients had significantly higher risk of diagnostic delay compared to
negative (OR=2.18. P=0.035). However, no significant associations found between
socio-economic/demographic classes with delay. Median delays was more amongst
married (Q
=86 Days, Median =72 days, Q1=24 Days compared to single/separated
(Q
3
3
=74 Days, Median =57 days, Q
=15 Days) and other socio-demographic variables
had no significant differences.
1
Conclusion
Delay in diagnosis and treatment in Urban region of Western, Nepal was shorter
compared to other places in Nepal and neighboring countries. Shorter delay for
smear negative pulmonary tuberculosis raises doubt that cases are not examined
according to the national TB control programs manual.
Keyword : Diagnostic delay, DOTS, Treatment delay, Tuberculosis
