title: Delays in seeking treatment for symptomatic tuberculosis in Sabah, East Malaysia: factors for patient delay.
abstract: METHODS
  The state of Sabah contributes one third of the tuberculosis (TB) cases in Malaysia.
  
  
  OBJECTIVE
  To collect information on factors that affect the time period from the onset of symptoms to first contact with health care providers, whether private or government.
  
  
  METHODS
  A cross-sectional study using a pre-tested questionnaire was conducted among 296 newly registered smear-positive TB patients in 10 districts in Sabah. Univariable and multivariable analyses were used to determine which risk factors were associated with patient delay (>30 days) and 'extreme'  patient delay (>90 days).
  
  
  RESULTS
  The percentage of patients who sought treatment after 30 and 90 days was respectively 51.8% (95%CI 45.7-57.9) and 23.5% (95%CI 18.6-29.0). The strongest factors associated with patient delay and 'extreme' patient delay was when  the first choice for treatment was a non-government health facility and in 30-39-year-olds. 'Extreme' patient delay was also weakly associated, among other factors, with comorbidity and livestock ownership.
  
  
  CONCLUSIONS
  Delay and extreme delay in seeking treatment were  more common when the usual first treatment choice was a non-government health facility. Continuous health education on TB aimed at raising awareness and correcting misconceptions is needed, particularly among those who use non-government facilities.
authors.affiliation: Sabah Health Department, Ministry of Health, Sabah, Malaysia. christinarundi@moh.gov.my
authors.forename: C
authors.initials: C
authors.lastname: Rundi
authors.forename: K
authors.initials: K
authors.lastname: Fielding
authors.forename: P
authors.initials: P
authors.lastname: Godfrey-Faussett
authors.forename: L C
authors.initials: LC
authors.lastname: Rodrigues
authors.forename: P
authors.initials: P
authors.lastname: Mangtani
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000822:Animal Husbandry; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education / Q000379:methods; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents