Abstract:
Background: A delayed initiation of tuberculosis treatment results in high morbidity, mortality, and increased
person-to-person transmissions. The aim of this study was to assess treatment delay and its associated factors
among adult drug resistant tuberculosis patients in the Amhara Regional State, Ethiopia.
Methods: An institution based cross-sectional study was conducted on all adult drug resistant tuberculosis patients
who initiated treatment from September 2010 to December 2017. Data were collected from patient charts,
registration books, and computer databases using abstraction sheets. The data were entered using Epi-info version
7 and exported to SPSS version 20 for analysis. Summary statistics, like means, medians, and proportions were used
to present it. Binary logistic regression was fitted; Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI)
was also computed. Variables with p-value < 0.05 in the multi-variable logistic regression model was declared as
significantly associated with treatment delay.
Results: The median time to commence treatment after drug resistant tuberculosis diagnosis was 8 (IQR:
3–37) days. Being diagnosed by Line probe assay [AOR = 5.59; 95% CI: 3.48–8.98], Culture [AOR = 5.15; 95% CI:
2.53–10.47], and history of injectable anti-TB drugs [AOR = 2.12; 95% CI: 1.41–3.19] were associated with
treatment delays.
Conclusion: Treatment delay was long, especially among patients diagnosed by Culture or LPA and those
who had a prior history of injectable anti-TB drugs. That suggested that the need for universal accesses to
rapid molecular diagnostic tests, such as Gene Xpert and the PMDT team were needed to promptly decide
to minimize unnecessary delays.
