Year: 2024 | Month: March | Volume: 14 | Issue: 3 | Pages: 170-177
DOI: https://doi.org/10.52403/ijhsr.20240325
Tuberculosis Diagnosis Delays and Associated Institutional Barriers Among Tertiary Hospitals in Tharaka Nithi County, Kenya
Linda B.K1, Onchangwa T.N1, Gitonga L.K1, Mukhwana E.S1, M’Kiunga K.S1
1School of Nursing and Public Health, Chuka University, Chuka, Kenya
Corresponding Author: Linda Bonface Kivuva
ABSTRACT
Globally, delayed diagnosis of Tuberculosis (TB) is a significant contributor to spread of TB despite avaiability of diagnostic aligorithm and advanced diagnostic machine. Kenya is still grouped among high TB burden nations and has the highest TB incidences in East Africa. This has been associated with delays in diagnosis, resulted to either individual or community health and economic challenges. The purpose of this study was to assess health system related factors influencing timely diagnosis of TB in Tharaka Nithi County. A descriptive crossectional survey study design was adopted among 154 randomly selected patients and 12 purposively selected key informants in selected hospitals in Tharaka Nithi County. A self administered questionaire and key informant guide were used to collect data among patients and key informants respectively. Descriptive and inferential statistics were used to analyse data. Bivariate analysis was used to test the strength of association between health system related factors and duration of TB before diagnosis. Qualitative data was analysed thematically. Study findings revealed that most (70.86%, n=107) respondents delayed in diagnosis. Bivariate regression results revealed that multiple visits (OR=3.24;95%CI:1.55-6.76,p=0.002), long turnarround time (OR=2.38 ;95% CI:1.06-5.30;p=0.035), cash payment (OR=4.53;95%CI:1.82-11.23; p= 0.001), far diagnostic centers (OR=3.86;95%CI:1.71-8.73;p=0.001),lack of prior TB health education (OR=2.71; 95%CI: 1.29-5.64;p=0.008) and long laboratory results turnarround time (OR=2.49; 95% CI: 1.29-5.64; p=0.016) as significants associated with delayed diagnosis. Machine breakdown, misdiagnosis, and inadequate counselling on TB were identified as precipiators of diagnostic delay within a hospital. The study recommends empowerment of community based-hospital referral system, strengthening of collaboration between County government and independent service providers, equiping health facility and continuous training on TB diagnosis and care.
Key words: Timely diagnosis, Health System Related, Tuberculosis, Delay, Barriers