Delays and care seeking behavior among tuberculosis patients in Tigray of Northern Ethiopia

Background: Delayed initiation of treatment among tuberculosis patients is a common problem which might contribute to the high burden of tuberculosis in Ethiopia. There is paucity of evidence on the magnitude of delay and why patients fail to seek modern care early in Tigray. Objectives: To assess patient and health service delays and factors for delay among tuberculosis patients. Methods: Adult tuberculosis patients who began treatment (12/10/2001-15/05/2002) in 47 public health institutions were interviewed using a pre-tested questionnaire to gather information about their health seeking behaviour. Patient charts were also reviewed to determine the magnitude of delays. Result: The median patient delay for 42 pulmonary smear positive, 101 pulmonary smear negative and 94 extra-pulmonary tuberculosis patients was 90 days, 60 days and 90 days respectively, while the overall median health service delay was 9 days. Delayed first consultation (>21 days since onset of illness) was significantly higher among patients with no formal education (Adjusted Odds Ratio (AOR)=2.46; 95%Confidence Interval (CI)=1.21-5.01), among those treated first by a private and/or traditional practitioner (AOR=2.9; 95% CI=1.42-6.08), among those who thought their illness not serious (AOR=2.39; 95% CI= 1.52-3.78) and among those who suspected they had tuberculosis (AOR=2.5; 95% CI=1.18-5.29). Conclusion: This unacceptably long patient delay calls for identification and inclusion of feasible strategies to promote early treatment in the national tuberculosis control program. The Ethiopian Journal of Health Development Vol. 19 2005: 7-1