Browsing by Author "Wambui, Milkah Wanjiru"

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    Determinants of Health-Seeking Behaviours Leading to Total Delay in Tuberculosis Treatment among Adult Patients in Kirinyaga County, Kenya
    (Kenyatta University, 2025-10) Wambui, Milkah Wanjiru
    Tuberculosis (TB) remains a significant global and national public health concern, especially in low- and middle-income countries. A major barrier to effective TB control is the presence of delays at different stages, including patient delay in seeking medical attention, diagnostic delay, and delay in starting treatment after diagnosis. Most transmission occurs between symptom onset and treatment initiation, with one untreated patient capable of infecting 10–15 others. Timely health-seeking behaviour and early treatment initiation are therefore essential to interrupt transmission and improve prognosis. This study determined the prevalence and determinants of total TB treatment delay among adult patients in Kirinyaga County, Kenya. A descriptive cross-sectional design was applied across five sub-counties, targeting adults newly diagnosed or in the intensive phase of TB treatment. A total of 246 patients participated. Quantitative data were collected using structured questionnaires on Kobo Toolbox, while qualitative data were gathered through focus group discussions (FGDs) and key informant interviews (KIIs). Total TB treatment delay was measured as the number of days from symptom onset (as recalled by patients) to treatment initiation, verified from facility registers. The study analyzed quantitative data using descriptive statistics, chi-square tests, and logistic regression, while qualitative data were analyzed thematically. Overall, 60.6% of patients experienced total TB treatment delay, with 27% reporting short, 28% moderate, and 45% long delays. Education level (p = 0.028), employment status (p = 0.010), and comorbidity (p < 0.001) were significant individual predictors. Socio-cultural factors such as stigma (p = 0.023) and discrimination (p < 0.001) were also associated with delay. Healthseeking behaviour strongly influenced delay: patients who sought care after weeks were less likely to delay compared to those who sought care within days (AOR = 0.47; 95% CI: 0.231–0.963; p = 0.039). In conclusion, the study established that total tuberculosis treatment delay remains prevalent in Kirinyaga County, largely influenced by stigma, socio-demographic factors, and health-seeking behaviors. Addressing these requires integrated community education, stigma reduction, and strengthened health-system measures for same-day diagnosis and prompt treatment initiation