Delay in the Diagnosis and Treatment of Tuberculosis among Tuberculosis Patients in South-East Delhi, India

Background: Delay in accessing effective health care plays an important role in tuberculosis (TB) transmission within the community. Objectives: The objectives of the study were (1) to estimate the total delays experienced by the patient before initiation of TB treatment and (2) to determine the factors associated with delays in the diagnosis and treatment of such patients. Materials and Methods: A cross-sectional study was conducted among TB patients enrolled in ten randomly selected directly observed treatment short-course (DOTS) centers in South-East Delhi from January 2019 to March 2020. During this period, 439 patients were approached, of which 416 consented to participate in the study. Patient delay, health system delay, and total delay were determined. The data were collected using questions from the “Tool to estimate patients’ costs” questionnaire. Results: Of the 416 participants, 62.2% were male. The mean age was 40.9 ± 16.33 years. The mean health system delay was 24.2 ± 3.85 days (median: 19 days). The mean patient delay was 25.27 ± 8.21 days (median: 29 days). Patient delay was seen in 36.3% of patients while health system delay occurred in 40.6%. The delays were significantly associated with the gender of the patient, their educational status, the type of facility first visited, the type of TB, and the category of TB. The mean time spent on the diagnosis of TB was 35.20 ± 17.5 h. Conclusion: In the present study, both patient and health system delays are associated with several factors. Addressing these barriers and reasons for the delays will help in the timely diagnosis and treatment of the patients.