Evaluation of health care seeking behaviour and various factors determining treatment delays among pulmonary tuberculosis patients attending a tertiary care hospital in North India

Background: When a person develops active Tuberculosis (TB), the symptoms such as productive cough, fever, night sweats and weight loss may be mild for many months. This can lead to delays in seeking health care. As delay in TB diagnosis may increase infectivity, worsen the disease state, and enhance the risk of death, hence, early diagnosis and prompt treatment remain essential components for effective tuberculosis control. Objectives: To study the health care seeking behaviour and factors determining the treatment delays among tuberculosis patients. Methodology: An Out Patients Department based, descriptive, observational study was carried out among adult pulmonary tuberculosis patients attending a tertiary care hospital. Detailed history and physical examination was done to assess the health care seeking behaviour and various factors associated with treatment delays. Results: Unacceptable delay in treatment of more than 8 weeks was present in 73.6% of patients. Delay was more in the age group < 40 years (OR = 5.39), among males (OR = 1.69), in patients from rural areas (OR= 1.81) and those who were either illiterate or primary educated (OR = 12.61). Unacceptable delay was also seen among unemployed and unskilled workers (OR = 7.27), and among patients of poor socioeconomic status (OR = 16.97). Conclusion: Increasing the awareness of tuberculosis symptoms to the general population, along with engagement of informal care providers and strengthening of existing public-private models should be done for timely diagnosis and treatment, thereby, helping in TB control.