Treatment seeking delay and associated factors among tuberculosis patients attending health facility in Ethiopia from 2000 to 2020: A systematic review and meta analysis.

<h4>Background</h4>Treatment seeking delay is defined as the time interval between the onset of the major symptoms of tuberculosis (TB) and the first visit to the formal health care facility. The patient was said to be delayed if the patient visited the health-facility after 3 weeks onse...

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Autores principales:	Mohammed Suleiman Obsa, Wakgari Binu Daga, Naol Gorde Wosene, Tsegaye Demeke Gebremedhin, Dinkisisa Chemeda Edosa, Abdurahman Tune Dedecho, Nefsu Awoke, Bedilu Girma Weji, Eyob Eshetu Bekele
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1775e43e37ba4b42b3485dbb4b040530
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spelling	oai:doaj.org-article:1775e43e37ba4b42b3485dbb4b0405302021-12-02T20:09:47ZTreatment seeking delay and associated factors among tuberculosis patients attending health facility in Ethiopia from 2000 to 2020: A systematic review and meta analysis.1932-620310.1371/journal.pone.0253746https://doaj.org/article/1775e43e37ba4b42b3485dbb4b0405302021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253746https://doaj.org/toc/1932-6203<h4>Background</h4>Treatment seeking delay is defined as the time interval between the onset of the major symptoms of tuberculosis (TB) and the first visit to the formal health care facility. The patient was said to be delayed if the patient visited the health-facility after 3 weeks onset of major symptoms. However, in low-income countries like Ethiopia, the delay in treatment-seeking among tuberculosis patients contributes to a widespread transmission and high prevalence of tuberculosis.<h4>Methods</h4>Studies were retrieved from PubMed, Cochrane Database, Cinahl, Scopus, Mednar, and Google Scholar by employing a combination of search terms with Boolean operators. Heterogeneity across studies was assessed using the Cochrane Q test. A funnel plot was used for visual assessment of publication bias. Subgroup analyses were performed to explore the possible causes of heterogeneity. Egger's weighted regression test at a p-value < 0.05 was used to assess the presence of publication bias. Sensitivity analysis was performed to judge whether the pooled effect size was influenced by individual study. STATA software version 14 was used for all statistical analyses.<h4>Result</h4>A total of 12 studies with 5122 total sample size were included. The national pooled prevalence of treatment seeking delay was 44.29% (95% CI: 39.805, 48.771). The visual inspection of the funnel plot showed the asymmetrical distribution, and the Egger test showed insignificant (P = 0.348). Patients who did not seek formal health care providers on a first contact had about 7 times more likely to delay than patients who sought formal health care provider on a first contact (OR: 7.192 ((95% CI 5.587-9.257), P = 0.001, I2: 85%). The others independent predictors of delay were rural residence (OR: 3.459 ((95% CI 1.469-8.148), P ≤ 0.001), extra pulmonary TB (OR: 2.520 ((95% CI 1.761-3.605), 0.180), lower educational level (OR 11.720 ((95% CI 1.006-2.938), P <0.001), and distance more than 10km from health facility (OR: 1.631 ((95% CI (10.858-3.101), P = 0.001).<h4>Conclusion</h4>In this review, we identified a substantial treatment seeking delay among TB patients in Ethiopia. And, the independent predictors of delay were treatment sought before formal health care provider, residence of the patient, type of TB, educational level, and distance from a health facility. Thus, we recommend health extension workers, health professionals and other stakeholders to focus on patient education, and to continuously mobilize the whole communities on early treatment seeking with a special emphasis given to where treatment sought before formal health care provider, rural resident, extra pulmonary TB, and a patient living farther than 10km distance from health facility.Mohammed Suleiman ObsaWakgari Binu DagaNaol Gorde WoseneTsegaye Demeke GebremedhinDinkisisa Chemeda EdosaAbdurahman Tune DedechoNefsu AwokeBedilu Girma WejiEyob Eshetu BekelePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253746 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mohammed Suleiman Obsa Wakgari Binu Daga Naol Gorde Wosene Tsegaye Demeke Gebremedhin Dinkisisa Chemeda Edosa Abdurahman Tune Dedecho Nefsu Awoke Bedilu Girma Weji Eyob Eshetu Bekele Treatment seeking delay and associated factors among tuberculosis patients attending health facility in Ethiopia from 2000 to 2020: A systematic review and meta analysis.
description	<h4>Background</h4>Treatment seeking delay is defined as the time interval between the onset of the major symptoms of tuberculosis (TB) and the first visit to the formal health care facility. The patient was said to be delayed if the patient visited the health-facility after 3 weeks onset of major symptoms. However, in low-income countries like Ethiopia, the delay in treatment-seeking among tuberculosis patients contributes to a widespread transmission and high prevalence of tuberculosis.<h4>Methods</h4>Studies were retrieved from PubMed, Cochrane Database, Cinahl, Scopus, Mednar, and Google Scholar by employing a combination of search terms with Boolean operators. Heterogeneity across studies was assessed using the Cochrane Q test. A funnel plot was used for visual assessment of publication bias. Subgroup analyses were performed to explore the possible causes of heterogeneity. Egger's weighted regression test at a p-value < 0.05 was used to assess the presence of publication bias. Sensitivity analysis was performed to judge whether the pooled effect size was influenced by individual study. STATA software version 14 was used for all statistical analyses.<h4>Result</h4>A total of 12 studies with 5122 total sample size were included. The national pooled prevalence of treatment seeking delay was 44.29% (95% CI: 39.805, 48.771). The visual inspection of the funnel plot showed the asymmetrical distribution, and the Egger test showed insignificant (P = 0.348). Patients who did not seek formal health care providers on a first contact had about 7 times more likely to delay than patients who sought formal health care provider on a first contact (OR: 7.192 ((95% CI 5.587-9.257), P = 0.001, I2: 85%). The others independent predictors of delay were rural residence (OR: 3.459 ((95% CI 1.469-8.148), P ≤ 0.001), extra pulmonary TB (OR: 2.520 ((95% CI 1.761-3.605), 0.180), lower educational level (OR 11.720 ((95% CI 1.006-2.938), P <0.001), and distance more than 10km from health facility (OR: 1.631 ((95% CI (10.858-3.101), P = 0.001).<h4>Conclusion</h4>In this review, we identified a substantial treatment seeking delay among TB patients in Ethiopia. And, the independent predictors of delay were treatment sought before formal health care provider, residence of the patient, type of TB, educational level, and distance from a health facility. Thus, we recommend health extension workers, health professionals and other stakeholders to focus on patient education, and to continuously mobilize the whole communities on early treatment seeking with a special emphasis given to where treatment sought before formal health care provider, rural resident, extra pulmonary TB, and a patient living farther than 10km distance from health facility.
format	article
author	Mohammed Suleiman Obsa Wakgari Binu Daga Naol Gorde Wosene Tsegaye Demeke Gebremedhin Dinkisisa Chemeda Edosa Abdurahman Tune Dedecho Nefsu Awoke Bedilu Girma Weji Eyob Eshetu Bekele
author_facet	Mohammed Suleiman Obsa Wakgari Binu Daga Naol Gorde Wosene Tsegaye Demeke Gebremedhin Dinkisisa Chemeda Edosa Abdurahman Tune Dedecho Nefsu Awoke Bedilu Girma Weji Eyob Eshetu Bekele
author_sort	Mohammed Suleiman Obsa
title	Treatment seeking delay and associated factors among tuberculosis patients attending health facility in Ethiopia from 2000 to 2020: A systematic review and meta analysis.
title_short	Treatment seeking delay and associated factors among tuberculosis patients attending health facility in Ethiopia from 2000 to 2020: A systematic review and meta analysis.
title_full	Treatment seeking delay and associated factors among tuberculosis patients attending health facility in Ethiopia from 2000 to 2020: A systematic review and meta analysis.
title_fullStr	Treatment seeking delay and associated factors among tuberculosis patients attending health facility in Ethiopia from 2000 to 2020: A systematic review and meta analysis.
title_full_unstemmed	Treatment seeking delay and associated factors among tuberculosis patients attending health facility in Ethiopia from 2000 to 2020: A systematic review and meta analysis.
title_sort	treatment seeking delay and associated factors among tuberculosis patients attending health facility in ethiopia from 2000 to 2020: a systematic review and meta analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/1775e43e37ba4b42b3485dbb4b040530
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Treatment seeking delay and associated factors among tuberculosis patients attending health facility in Ethiopia from 2000 to 2020: A systematic review and meta analysis.

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