Factors influencing delayed treatment among smear positive pulmonary tuberculosis patients

INTRODUCTION TB remains a great challenge to public health in Malaysia and worldwide. Delay in treatment commencement can result in significant increase morbidity, mortality and transmission. Hence this study is aimed to determine the prevalence of various delays (patient, health service, diagno...

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Main Author:	Abdullah, Noor Hashimah
Format:	Thesis
Language:	English
Published:	2006
Subjects:	RC705-779 Diseases of the respiratory system
Online Access:	http://eprints.usm.my/47619/1/DR.%20NOOR%20HASHIMAH%20BINTI%20ABDULLAH-24%20pages.pdf
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spelling	my-usm-ep.476192020-10-20T06:57:07Z Factors influencing delayed treatment among smear positive pulmonary tuberculosis patients 2006 Abdullah, Noor Hashimah RC705-779 Diseases of the respiratory system INTRODUCTION TB remains a great challenge to public health in Malaysia and worldwide. Delay in treatment commencement can result in significant increase morbidity, mortality and transmission. Hence this study is aimed to determine the prevalence of various delays (patient, health service, diagnosis, initiation and total delay) and to identify the factors influencing the patient delay and health service delay. METHOD A crossectional study was done from October 2004 to June 2005 among 178 smear positive pulmonary TB patients in four districts in Kelantan (Kota Bharu, Tumpat, Bachok and Pasir Mas). All patients who fulfilled the inclusion and exclusion criteria and gave consent were recruited due to limited number of patients. Interviewer guided questionnaire was administered and medical record was reviewed to gather patient's information. RESULT The median and inter-quartile range of patient delay, health service delay, diagnosis delay, initiation delay and total treatment delay in days were 30.0(76.00), 7.0(14.50), 3.0(4.00), 3.0(4.00) and 64.0(90.25) respectively. Furthermore, the prevalence and 95%CI of unacceptable delays; patient delay, health service delay, diagnosis delay, initiation delay and total treatment delay were 46.6%(39.3, 53.3), 45.5%(38.2, 52.8), 48.3%(41.0,55.6), 37.6%(30.5,44.8), 61.8% (54.7,68.9) respectively. In multiple logistic regression analysis, the significant factors associated with unacceptable patient delay were age (OR: 3.88;95%CI: 1.35, 11.18; p= 0.0 12), distance from home to first health facilities attended (OR: 3.98; 95%CI: 1.56, 1 0.15; p= 0.004), attending the T/CM practitioners (OR: 10.51; 95%CI, 1.80, 55.39; p=0.006), attending the private practitioners (OR: 0.24, 95%CI: 0.09, 0.60; p= 0.002) and stigma (OR: 4.81; 95%CI: 1.59, 14.60; p=0.006). On the other hand, the significant factors associated with unacceptable health service delay were negative results of initial sputum smear (OR: 14.48; 95%CI: 2.30, 91.34; p=0.004), number of visits to health facilities (OR: 4.99 95%CI: 2.76, 9.03; p= <0.001) and types of first health care facilities attended (OR: 5. 78; 95%CI: 1.58, 21.11; p= 0.008) CONCLUSION This study showed that there was a substantial delay in case finding in Kelantan. Raising public awareness about symptoms of TB, curability and benefit of utilizing available governmental health facilities through health education campaign might shorten the patient delay. Health care personnel in both private and government sectors should be reminded on the important of early diagnosis and prompt treatment of TB. Traditional and complementary practitioners should be well-cooperated in contributing to Malaysian health care system by interacting with both private and governmental health sectors. 2006 Thesis http://eprints.usm.my/47619/ http://eprints.usm.my/47619/1/DR.%20NOOR%20HASHIMAH%20BINTI%20ABDULLAH-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RC705-779 Diseases of the respiratory system
spellingShingle	RC705-779 Diseases of the respiratory system Abdullah, Noor Hashimah Factors influencing delayed treatment among smear positive pulmonary tuberculosis patients
description	INTRODUCTION TB remains a great challenge to public health in Malaysia and worldwide. Delay in treatment commencement can result in significant increase morbidity, mortality and transmission. Hence this study is aimed to determine the prevalence of various delays (patient, health service, diagnosis, initiation and total delay) and to identify the factors influencing the patient delay and health service delay. METHOD A crossectional study was done from October 2004 to June 2005 among 178 smear positive pulmonary TB patients in four districts in Kelantan (Kota Bharu, Tumpat, Bachok and Pasir Mas). All patients who fulfilled the inclusion and exclusion criteria and gave consent were recruited due to limited number of patients. Interviewer guided questionnaire was administered and medical record was reviewed to gather patient's information. RESULT The median and inter-quartile range of patient delay, health service delay, diagnosis delay, initiation delay and total treatment delay in days were 30.0(76.00), 7.0(14.50), 3.0(4.00), 3.0(4.00) and 64.0(90.25) respectively. Furthermore, the prevalence and 95%CI of unacceptable delays; patient delay, health service delay, diagnosis delay, initiation delay and total treatment delay were 46.6%(39.3, 53.3), 45.5%(38.2, 52.8), 48.3%(41.0,55.6), 37.6%(30.5,44.8), 61.8% (54.7,68.9) respectively. In multiple logistic regression analysis, the significant factors associated with unacceptable patient delay were age (OR: 3.88;95%CI: 1.35, 11.18; p= 0.0 12), distance from home to first health facilities attended (OR: 3.98; 95%CI: 1.56, 1 0.15; p= 0.004), attending the T/CM practitioners (OR: 10.51; 95%CI, 1.80, 55.39; p=0.006), attending the private practitioners (OR: 0.24, 95%CI: 0.09, 0.60; p= 0.002) and stigma (OR: 4.81; 95%CI: 1.59, 14.60; p=0.006). On the other hand, the significant factors associated with unacceptable health service delay were negative results of initial sputum smear (OR: 14.48; 95%CI: 2.30, 91.34; p=0.004), number of visits to health facilities (OR: 4.99 95%CI: 2.76, 9.03; p= <0.001) and types of first health care facilities attended (OR: 5. 78; 95%CI: 1.58, 21.11; p= 0.008) CONCLUSION This study showed that there was a substantial delay in case finding in Kelantan. Raising public awareness about symptoms of TB, curability and benefit of utilizing available governmental health facilities through health education campaign might shorten the patient delay. Health care personnel in both private and government sectors should be reminded on the important of early diagnosis and prompt treatment of TB. Traditional and complementary practitioners should be well-cooperated in contributing to Malaysian health care system by interacting with both private and governmental health sectors.
format	Thesis
qualification_level	Master's degree
author	Abdullah, Noor Hashimah
author_facet	Abdullah, Noor Hashimah
author_sort	Abdullah, Noor Hashimah
title	Factors influencing delayed treatment among smear positive pulmonary tuberculosis patients
title_short	Factors influencing delayed treatment among smear positive pulmonary tuberculosis patients
title_full	Factors influencing delayed treatment among smear positive pulmonary tuberculosis patients
title_fullStr	Factors influencing delayed treatment among smear positive pulmonary tuberculosis patients
title_full_unstemmed	Factors influencing delayed treatment among smear positive pulmonary tuberculosis patients
title_sort	factors influencing delayed treatment among smear positive pulmonary tuberculosis patients
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2006
url	http://eprints.usm.my/47619/1/DR.%20NOOR%20HASHIMAH%20BINTI%20ABDULLAH-24%20pages.pdf
_version_	1747821808989503488

Factors influencing delayed treatment among smear positive pulmonary tuberculosis patients

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