Tuberculosis is a major public health concern worldwide, particularly in low-income countries such as Ethiopia. Delays are among the greatest challenges in tuberculosis control. However, evidence is scarce regarding patient delay and context-specific contributors. Therefore, this study aimed to assess the delay in seeking health facilities and its contributors in the South Gondar Zone. A sequential explanatory mixed cross-sectional study with a phenomenological design was conducted among 332 tuberculosis patients from 26 public health facilities in the South Gondar Zone. Data were collected via face-to-face interviews, entered using EpiData version 4.6, and exported to SPSS version 26 for analysis. Patient delay as an outcome variable was declared if the patient did not visit a health facility within three weeks. A binary logistic regression model was used to identify associated factors. In-depth interviews were conducted with ten tuberculosis patients, and thematic content analysis was applied. The quantitative findings were triangulated using the qualitative data. Of the study participants, 242 (72.9%) delayed to seek care at health facilities. Living in rural areasAOR = 2.12:95%CI(1.05,4.26), smear negative pulmonary-tuberculosisAOR = 8.08:95%CI(3.04,21.43), extra-pulmonary-tuberculosisAOR = 2.77: 95% CI (1.19, 6.47), HIV co-infectionAOR = 0.18:95%CI(0.07, 0.47), having moderate symptomsAOR = 2.96:95%CI(1.41, 6.22), having coughAOR = 0.18:95%CI(0.07, 0.43), no health facility visit within a yearAOR = 3.519:95%CI(1.25, 9.87), visiting a traditional healerAOR = 5.611:95%CI(2.42, 12.97), and self-medicationAOR = 2.633:95%CI (1.30, 5.33) were predictors of patient delay. Furthermore, from the qualitative data, living in rural areas, seeking informal providers, and knowledge constraints contributed to patient delay. The magnitude of tuberculosis patient delay was high, which was explained by rural residency, smear-negative tuberculosis, HIV co-infection, first visit to a traditional healer, self-medication practice, and poor knowledge of tuberculosis symptoms. To reduce patient delay, increasing public awareness of tuberculosis symptoms, improving public health-seeking behavior, integrated care, strengthening the health system, and clinician training should be promoted.
Yemata et al. (Wed,) studied this question.