Setting: Daru General Hospital, Daru Island, Papua New
Guinea, where high rates of tuberculosis (TB) have been
reported. Prompt diagnosis and effective treatment are
needed for improving TB outcomes and to prevent nosocomial transmission.
Objective: To assess the time to treatment initiation and
the risk factors associated with delayed treatment for patients started on TB treatment at Daru General Hospital
from January to September 2017.
Design: This was a retrospective cohort study that entailed reviewing the records from treatment, admission,
discharge and presumptive TB registers.
Results: The study included 360 patients on TB treatment. The median time from presentation to treatment
initiation was 7 days [IQR 3–11]. Treatment was started
7 days for 215 patients (60%); however, only 16.2%
commenced treatment 2 days. Risk factors for delayed
treatment were diagnosis of TB as an inpatient (OR 2.67,
95% CI 1.35–5.28, P = 0.005) and having drug-resistant
TB (OR 2.65, 95% CI 1.5–4.68. P = 0.001).
Conclusion: A high proportion of TB patients commenced treatment 7 days. Inpatient status, DR-TB and
lack of microbiological confirmation were associated with
delays in treatment initiation. We recommend that programmes monitor the time from presentation to treatment initiation, and propose that a period of >3 days
from presentation to treatment initiation be considered
as delayed treatment initiation.
Link to publisher’s web site