Factors that influence diagnostic delay among pulmonary tuberculosis patients in Osogbo, Nigeria

Abstract

Objectives: Delay in the diagnosis of pulmonary tuberculosis (TB) is reportedly common in Nigeria. This results in delayed initiation of treatment and increased spread of the disease. This study assessed diagnostic delay and its influencing factors among pulmonary TB patients who were attending directly observed treatment clinics in Osogbo, Nigeria. Materials and Methods: This descriptive cross-sectional study was carried out from August to October 2019 in 10 directly observed treatment clinics in Olorunda Local Government Area, Osogbo, Osun State, Nigeria. Multistage random sampling was used to select 280 registered TB patients. Data were collected using an interviewer-administered semi-structured questionnaire and analyzed with Statistical Package for the Social Sciences version 23. Results: Most respondents, that is, 220 (80.3%) were Yoruba, 69 (25.2%) had tertiary education, and 53 (19.3%) had no education at all. Only 135 (49.3%) respondents had good knowledge of pulmonary TB. We found that 157 (57.3%) respondents had patient-related diagnostic delays, while 135 (49.3%) had health system-related delays. Median patient-related delay was 1 month, while median health system-related delay was 3 weeks. There was no significant association between patient-related delay and any sociodemographic characteristic, knowledge about TB, or perceived attitude of health care workers. A significant difference in health-system-related delay was found concerning the attitude of health care workers toward patients (P = 0.043) and patients’ religion (P = 0.030), and level of education (P = 0.001). Conclusion: While pulmonary TB is common in the lower socioeconomic class, health workers should be open-minded while evaluating all patients to ensure correct and prompt diagnosis. A good attitude of health workers towards patients is important for preventing diagnostic delays.