The International Journal of Mycobacteriology

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 10  |  Issue : 4  |  Page : 364--372

Impact of early chest radiography on delay in pulmonary tuberculosis case notification in Ethiopia


Hussen Mohammed1, Lemessa Oljira2, Kedir Teji Roba3, Esther Ngadaya4, Dagmawit Tesfaye6, Tsegahun Manyazewal6, Getnet Yimer5 
1 Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa; Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
2 Department of Public Health, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
3 Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
4 Muhimbili Research Centre, National Institute for Medical Research, Dares Saalem, Tanzania
5 Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University; Ohio State Global One Health Initiative, Office of International Affairs, The Ohio State University, Addis Ababa, Ethiopia

Correspondence Address:
Hussen Mohammed
Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia; Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health and Medical Sciences, Addis Ababa University, P O Box 1362, Dire Dawa
Ethiopia

Background: One-third of tuberculosis (TB) cases are missed each year and delays in the diagnosis of TB are hampering the whole cascade of care. Early chest X-ray (CXR) in patients with cough irrespective of duration may reduce TB diagnostic and treatment delays and increase the number of TB patients put into TB care. We aimed to evaluate the impact of CXR on delay in the diagnosis of pulmonary tuberculosis (PTB) among people with cough of any duration. Methods: A facility-based cross-sectional study was conducted in four selected health facilities from two regions and two city administrations of Ethiopia. Patients who sought health care were screened for cough of any duration, and those with cough underwent CXR for PTB and their sputum specimens were tested for microbiological confirmation. Delays were followed up and calculated using median and inter-quartile range (IQR) to summarize (first onset of cough to first facility visit, ≥15 days), diagnosis delay (first facility visit to date of PTB diagnosis, >7 days), and total delay (first onset of cough to date of PTB diagnosis, >21 days). Kruskal–Wallis and Mann–Witney tests were used to compare the delays among independent variables. Results: A total of 309 PTB cases were consecutively diagnosed of 1853 presumptive TB cases recruited in the study that were identified from 2647 people who reported cough of any duration. The median (IQR) of patient delay, diagnosis delay, and the total delay was 30 (16–44), 1 (0–3), and 31 (19–48) days, respectively. Patients' delay contributed a great role in the total delay, 201/209 (96.2%). Median diagnosis delay was higher among those that visited health center, diagnosed at a facility that had no Xpert mycobacterium tuberculosis (MTB)/RIF assay, radiologist, or CXR (P < 0.05). Factors associated with patients delay were history of previous TB treatment (adjusted prevalence ratio [aPR] = 0.79, 95% confidence interval [CI]: 0.63–0.99) and history of weight loss (aPR = 1.12; 95% CI: 1.0–1.25). Early CXR screening for cough of <2 weeks duration significantly reduced the patients' delay and thus the total delay, but not diagnostic delay alone. Conclusion: Early screening using CXR minimized delays in the diagnosis of PTB among people with cough of any duration. Patients' delay was largest and contributed great role in the delay of TB cases. Screening by cough of any duration and/or CXR among people seeking healthcare along with ensuring the availability of Xpert MTB/RIF assay and skilled human power at primary healthcare facilities are important to reduce patient and diagnostic delays of PTB in Ethiopia.


How to cite this article:
Mohammed H, Oljira L, Roba KT, Ngadaya E, Tesfaye D, Manyazewal T, Yimer G. Impact of early chest radiography on delay in pulmonary tuberculosis case notification in Ethiopia.Int J Mycobacteriol 2021;10:364-372


How to cite this URL:
Mohammed H, Oljira L, Roba KT, Ngadaya E, Tesfaye D, Manyazewal T, Yimer G. Impact of early chest radiography on delay in pulmonary tuberculosis case notification in Ethiopia. Int J Mycobacteriol [serial online] 2021 [cited 2022 Jan 21 ];10:364-372
Available from: https://www.ijmyco.org/article.asp?issn=2212-5531;year=2021;volume=10;issue=4;spage=364;epage=372;aulast=Mohammed;type=0