Factors Contributing to the Delay in the Initiation of Treatment of Patients Enrolled in the TB DOTS Program in a Highly-Urbanized City in the Philippines

Frances Evangeline S. Vista,1 Monaflor Abigail G. Ignacio,1 Danica Marie C. Bausa,1
Danica Francia D. Lanuza,1 Justin Paul M. Mijares,1 Carl Abelardo T. Antonio2

1College of Public Health, University of the Philippines Manila
2Department of Health Policy and Administration,
College of Public Health, University of the Philippines Manila

Objective. The main objective of the study is to determine the factors which contribute to the delay in the initiation of treatment of TB patients enrolled in the TB control program in a highly urbanized city in the Philippines.

Methods. A descriptive, cross-sectional study was conducted in 14 health centers in the city; from which the proportion of TB patients who experienced delay in the initiation of treatment (>1 day after diagnosis) was obtained through records review. The health system and patient factors which contributed to the patients' delay were determined through face-to-face interviews. The information obtained was analyzed with supplemental information from interviews with selected health workers in the tuberculosis control program of the city.

Results. These showed that 20.95% of the TB patients enrolled in the TB control program of the city experienced delay in the initiation of treatment. They experienced a mean delay of 9.48 days. The health system and patient factors which affected the patients the most were the referral system (24.5%) and conflict between treatment and work or household responsibilities (22.4%), respectively.

Conclusion. These existing delays imply the need to implement interventions directed to improving current measures to control TB in the country.

Key Words: time-to-treatment, tuberculosis, pulmonary, directly observed therapy, Philippines