ABSTRACT:
The trend of tuberculosis is increasing globally. The morbidity, mortality and transmission of tuberculosis significantly increase in delaying the treatment. Hence this study was aimed to determine the prevalence of health service, diagnosis, and initiation delay and to identify the factors influencing the unacceptable health service delay. A cross sectional study was conducted from January to June 2005 among 178 smear positive pulmonary tuberculosis patients in four districts in Kelantan, Malaysia. All sputum smear positive pulmonary tuberculosis patients from September 2004 to June 2005 who fulfilled the inclusion and exclusion criteria and gave consent were recruited due to limited number of patients using the interviewer guided questionnaire. Multiple logistic regression was used in identifying the factors influencing the unacceptable health service delay. The prevalence of unacceptable delays; health service delay, diagnosis delay and initiation delay were 45.5%, 48.3% and 37.6% respectively. The significant factors associated with health service delay were negative results of initial sputum smear (Adjusted OR: 14.48; 95%CI: 2.30, 91.34), number of visits to health facilities (Adjusted OR: 4.99; 95%CI: 2.76, 9.03) and types of first health care facilities attended (Adjusted OR: 5.78; 95%CI: 1.58, 21.11). Health care personnel in government sectors should be reminded on the important of early diagnosis and prompt treatment of tuberculosis.