Gender Differences in Factors Associated with the Total Delay in Treatment of Pulmonary Tuberculosis Patients: A Cross-Sectional Study in Selangor, Malaysia

Kee Chee Cheong; Sumarni Mohd Ghazali; Ahmed Syahmi Syafiq Md Zamri; Yoon Ling Cheong; Nuur Hafizah Md Iderus; Tharmarajah Nagalingam; Qistina Ruslan; Mohd Azahadi Omar; Ahmad Faudzi Yusoff

doi:10.3390/ijerph19106258

Gender Differences in Factors Associated with the Total Delay in Treatment of Pulmonary Tuberculosis Patients: A Cross-Sectional Study in Selangor, Malaysia

Int J Environ Res Public Health. 2022 May 21;19(10):6258. doi: 10.3390/ijerph19106258.

Authors

Kee Chee Cheong¹, Sumarni Mohd Ghazali², Ahmed Syahmi Syafiq Md Zamri², Yoon Ling Cheong³, Nuur Hafizah Md Iderus², Tharmarajah Nagalingam⁴, Qistina Ruslan², Mohd Azahadi Omar¹, Ahmad Faudzi Yusoff⁵

Affiliations

¹ Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia.
² Biomedical Epidemiology Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia.
³ Biomedical Museum, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia.
⁴ Kuala Lumpur Hospital, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia.
⁵ SEAMEO TROPMED Malaysia, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia.

Abstract

Background: Gender plays a significant role in health-care-seeking behavior for many diseases. Delays in seeking treatment, diagnosis, and treatment for pulmonary tuberculosis (pTB) may increase the risk of transmission in the community and lead to poorer treatment outcomes and mortality. This study explores the differences in factors associated with the total delay in treatment of male and female pTB patients in Selangor, Malaysia. Methods: A cross-sectional study was conducted from January 2017 to December 2017. Newly diagnosed pTB patients (≥18 years) were recruited from selected government health clinics and hospitals in Selangor during the specified study period. An interviewer-administered questionnaire was used to collect information on sociodemographic characteristics, lifestyle, knowledge about pTB, stigma, distance to the nearest health facility, and chronology of pTB symptom onset, diagnosis, and treatment. The total delay was measured as the length of time between the onset of pTB symptoms to treatment initiation. Factors significantly associated with a longer total delay among men and women were identified using binary logistic regression. Results: A total of 732 patients (61.5% men, 38.5% women) were enrolled in the study. The median total delay was 60 days. Men who have weight loss as a symptom (AOR: 1.63, 95%CI: 1.10-2.41) and are employed (1.89, 1.15-3.11) were more likely to have a longer total delay, while those who know others who have had pTB (0.64, 0.43-0.96) were less likely to have a longer total delay. On the other hand, among women, having a stigma towards TB (0.52, 0.32-0.84) and obtaining a pTB diagnosis at the first medical consultation (0.48, 0.29-0.79) were associated with a shorter total delay. Conclusion: Factors associated with the total delay in pTB treatment were different for male and female pTB patients. Increasing awareness of pTB symptoms and the importance of seeking early medical consultation and a prompt diagnosis among the general public may reduce total delay in pTB treatment.

Keywords: delay; gender; pulmonary tuberculosis; stigma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Female
Humans
Malaysia / epidemiology
Male
Sex Factors
Time Factors
Time-to-Treatment*
Tuberculosis, Pulmonary* / diagnosis
Tuberculosis, Pulmonary* / drug therapy
Tuberculosis, Pulmonary* / epidemiology

Grants and funding

This study was funded by the National Institutes of Health Malaysia that supported the conduct of the study and publication fee. The funders had no role in the study design, analysis, and preparation of the manuscript.