Determinants of Health-Seeking Behaviours Leading to Total Delay in Tuberculosis Treatment among Adult Patients in Kirinyaga County, Kenya
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Date
2025-10
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Kenyatta University
Abstract
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
Description
A Research Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Public Health (Epidemiology & Disease Control) in the School of Health Sciences of Kenyatta University, October, 2025
Supervisor:
1.John Oyore
2.Harun Kimani