title: Delay for First Consultation and Its Associated Factors among New Pulmonary Tuberculosis Patients of Central Nepal.
abstract: Tuberculosis (TB) is still a major public health challenge in Nepal and worldwide. Most transmissions occur between the onset of symptoms and the consultation with formal health care centers. This study aimed to determine the duration of delay for the first consultation and its associated factors with unacceptable delay among the new sputum pulmonary tuberculosis cases in the central development region of Nepal. An analytical cross-sectional study was conducted in the central development region of Nepal between January and May 2015. New pulmonary sputum positive tuberculosis patients were interviewed by using a structured questionnaire and their medical records were reviewed. Among a total of 374 patients, the magnitude of patient delay was 53.21% (95% CI: 48.12-58.28%) with a median delay of 32 days and an interquartile range of 11-70 days. The factors associated with unacceptable patient delay (duration ≥ 30 days) were residence in the rural area (adj. OR = 3.10, 95% CI: 1.10-8.72; p value = 0.032) and DOTS center located more than 5 km away from their residences (adj. OR = 5.53, 95% CI: 2.18-13.99; p value < 0.001). Unemployed patients were more likely to have patient delay (adj. OR = 7.79, 95% CI: 1.64-37.00; p value = 0.010) when controlled for other variables.
authors.affiliation: Board Committee of Research and Training Centre for Enhancing Quality of Life of Working Age People (REQW), Khon Kaen University, Khon Kaen, Thailand; Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Wongsa
authors.identifier: 0000-0001-7838-716X
authors.initials: W
authors.lastname: Laohasiriwong
authors.affiliation: Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Roshan Kumar
authors.initials: RK
authors.lastname: Mahato
authors.affiliation: Departments of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Koju
authors.affiliation: Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Kriangsak
authors.initials: K
authors.lastname: Vaeteewootacharn