Treatment delay and associated factors among adults with drug resistant tuberculosis at treatment initiating centers in the Amhara regional state, Ethiopia

Abstract Background A delayed initiation of tuberculosis treatment results in high morbidity, mortality, and increased person-to-person transmissions. The aim of this study was to assess treatment delay and its associated factors among adult drug resistant tuberculosis patients in the Amhara Regiona...

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Main Authors: Kenaw Tegegne Tefera, Nebiyu Mesfin, Mebratu Mitiku Reta, Malede Mequanent Sisay, Koku Sisay Tamirat, Temesgen Yihunie Akalu
Format: Article
Language:English
Published: BMC 2019-05-01
Series:BMC Infectious Diseases
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12879-019-4112-2
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spelling doaj-5a551397c50d403fac828e8b78068fa32020-11-25T03:59:05ZengBMCBMC Infectious Diseases1471-23342019-05-011911810.1186/s12879-019-4112-2Treatment delay and associated factors among adults with drug resistant tuberculosis at treatment initiating centers in the Amhara regional state, EthiopiaKenaw Tegegne Tefera0Nebiyu Mesfin1Mebratu Mitiku Reta2Malede Mequanent Sisay3Koku Sisay Tamirat4Temesgen Yihunie Akalu5University of Gondar Comprehensive Specialized HospitalDepartment of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of GondarDepartment of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of GondarDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarAbstract Background A delayed initiation of tuberculosis treatment results in high morbidity, mortality, and increased person-to-person transmissions. The aim of this study was to assess treatment delay and its associated factors among adult drug resistant tuberculosis patients in the Amhara Regional State, Ethiopia. Methods An institution based cross-sectional study was conducted on all adult drug resistant tuberculosis patients who initiated treatment from September 2010 to December 2017. Data were collected from patient charts, registration books, and computer databases using abstraction sheets. The data were entered using Epi-info version 7 and exported to SPSS version 20 for analysis. Summary statistics, like means, medians, and proportions were used to present it. Binary logistic regression was fitted; Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was also computed. Variables with p-value < 0.05 in the multi-variable logistic regression model was declared as significantly associated with treatment delay. Results The median time to commence treatment after drug resistant tuberculosis diagnosis was 8 (IQR: 3–37) days. Being diagnosed by Line probe assay [AOR = 5.59; 95% CI: 3.48–8.98], Culture [AOR = 5.15; 95% CI: 2.53–10.47], and history of injectable anti-TB drugs [AOR = 2.12; 95% CI: 1.41–3.19] were associated with treatment delays. Conclusion Treatment delay was long, especially among patients diagnosed by Culture or LPA and those who had a prior history of injectable anti-TB drugs. That suggested that the need for universal accesses to rapid molecular diagnostic tests, such as Gene Xpert and the PMDT team were needed to promptly decide to minimize unnecessary delays.http://link.springer.com/article/10.1186/s12879-019-4112-2Drug resistant tuberculosisTreatment delayRisk factorsAmhara region
collection DOAJ
language English
format Article
sources DOAJ
author Kenaw Tegegne Tefera
Nebiyu Mesfin
Mebratu Mitiku Reta
Malede Mequanent Sisay
Koku Sisay Tamirat
Temesgen Yihunie Akalu
spellingShingle Kenaw Tegegne Tefera
Nebiyu Mesfin
Mebratu Mitiku Reta
Malede Mequanent Sisay
Koku Sisay Tamirat
Temesgen Yihunie Akalu
Treatment delay and associated factors among adults with drug resistant tuberculosis at treatment initiating centers in the Amhara regional state, Ethiopia
BMC Infectious Diseases
Drug resistant tuberculosis
Treatment delay
Risk factors
Amhara region
author_facet Kenaw Tegegne Tefera
Nebiyu Mesfin
Mebratu Mitiku Reta
Malede Mequanent Sisay
Koku Sisay Tamirat
Temesgen Yihunie Akalu
author_sort Kenaw Tegegne Tefera
title Treatment delay and associated factors among adults with drug resistant tuberculosis at treatment initiating centers in the Amhara regional state, Ethiopia
title_short Treatment delay and associated factors among adults with drug resistant tuberculosis at treatment initiating centers in the Amhara regional state, Ethiopia
title_full Treatment delay and associated factors among adults with drug resistant tuberculosis at treatment initiating centers in the Amhara regional state, Ethiopia
title_fullStr Treatment delay and associated factors among adults with drug resistant tuberculosis at treatment initiating centers in the Amhara regional state, Ethiopia
title_full_unstemmed Treatment delay and associated factors among adults with drug resistant tuberculosis at treatment initiating centers in the Amhara regional state, Ethiopia
title_sort treatment delay and associated factors among adults with drug resistant tuberculosis at treatment initiating centers in the amhara regional state, ethiopia
publisher BMC
series BMC Infectious Diseases
issn 1471-2334
publishDate 2019-05-01
description Abstract Background A delayed initiation of tuberculosis treatment results in high morbidity, mortality, and increased person-to-person transmissions. The aim of this study was to assess treatment delay and its associated factors among adult drug resistant tuberculosis patients in the Amhara Regional State, Ethiopia. Methods An institution based cross-sectional study was conducted on all adult drug resistant tuberculosis patients who initiated treatment from September 2010 to December 2017. Data were collected from patient charts, registration books, and computer databases using abstraction sheets. The data were entered using Epi-info version 7 and exported to SPSS version 20 for analysis. Summary statistics, like means, medians, and proportions were used to present it. Binary logistic regression was fitted; Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was also computed. Variables with p-value < 0.05 in the multi-variable logistic regression model was declared as significantly associated with treatment delay. Results The median time to commence treatment after drug resistant tuberculosis diagnosis was 8 (IQR: 3–37) days. Being diagnosed by Line probe assay [AOR = 5.59; 95% CI: 3.48–8.98], Culture [AOR = 5.15; 95% CI: 2.53–10.47], and history of injectable anti-TB drugs [AOR = 2.12; 95% CI: 1.41–3.19] were associated with treatment delays. Conclusion Treatment delay was long, especially among patients diagnosed by Culture or LPA and those who had a prior history of injectable anti-TB drugs. That suggested that the need for universal accesses to rapid molecular diagnostic tests, such as Gene Xpert and the PMDT team were needed to promptly decide to minimize unnecessary delays.
topic Drug resistant tuberculosis
Treatment delay
Risk factors
Amhara region
url http://link.springer.com/article/10.1186/s12879-019-4112-2
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