The Determinants of Treatment Delay and Quality of Life among the Newly Diagnosed Pulmonary Tuberculosis Patients in Northeastern Thailand: A Cross-Sectional Study.

Abstract

Background/objective: Delays in diagnosing pulmonary tuberculosis (PTB) are linked to financial difficulties, employment limits, dependency, and symptomatic treatment, all of which have an impact on the patient's quality of life. Patients' psychological, economic, and social well-being are also harmed by delayed therapy. The goal of this research was to evaluate sociodemographic characteristics and quality of life in new pulmonary TB patients and determine the associated factors with delayed TB diagnosis.

Methods: This was a cross-sectional study conducted in the Choke Chai Community Hospital, in Northeastern Thailand between 2016 and 2018. The information related to the patient's medical history and laboratory tests were gathered from 332 newly diagnosed tuberculosis patients at the hospital's tuberculosis clinic; of those 15 died and were excluded from the final analysis. Data were analyzed using SPSS version 17.0.

Results: The cases included new cases (94%) and those returning to receive treatment after discontinuation of treatment, relapse, or recurrence of the disease (6%). The sample consisted of 68.7% males and 31.3% females. The average age was 52.7 years (S.D = 15.64). The majority of patients were married (60.5%), employed (68.6%), received a low income (66.6%), had a history of chronic diseases (73%), drank alcohol (31.7%), and smoked (85.7%). Approximately half of PTB experienced treatment delay and had a low quality of life (QoL) (46.6%). The treatment delay was associated with age > 50 years (p <0.05), low self-care (p <0.05), long distance to facility (p <0.05), unavailable caretaker to treat (p <0.05), no caregiver in family (p <0.05), high expenses (p <0.01), and lack of information (p <0.001).

Conclusion: It appeared that the patients' health-related quality of life could be deteriorated as a result of pulmonary tuberculosis. Treatment delays can be significantly reduced by changing the understanding of family caregivers, increasing awareness, providing adequate support for patients, and guaranteeing early diagnosis and treatment by implementing an efficient surveillance system.