Factors Associated with Delay in Diagnosis of Tuberculosis among Newly Diagnosed Patients in Meru County

TB remains a disease of major public health concern due to related mortality and morbidity. Kenya is a high-burden country for TB and TB/HIV, and an estimated 1330,000 people got TB in 2022, but only 90,560 were diagnosed, and over 30% were missed. Delay in TB diagnosis fuels community TB transmission and poor treatment outcomes. This study was conducted to determine the factors associated with delay in TB diagnosis among newly diagnosed TB patients in Meru County. This was a cross-sectional study involving freshly diagnosed TB patients in 7 health facilities in Meru County. A semi-structured questionnaire was used to collect data. Descriptive analysis, median time to seeking care, and median time to diagnosis were done. Chi-square and t-tests were carried out to determine the relationship between delay in diagnosis and various patients, diseases, and health system characteristics. Odd ratios were carried out for the factors found to be significant to determine the strength of the relationship. A total of 390 participants were enrolled; 299 (76.7%) males and 91 (23.3%) females. The median time to diagnosis was 40 days; 20 (3, 40) days patients delay and 20 (3, 40) days of health system delay. Of the 390 patients recruited, 359 (92.1%) delayed being diagnosed, while 31 (7.9%) did not. The factors associated with delay to diagnosis were: the Subcounty where participants sought care, having cough, weight loss, or chest pains as one of the presenting symptoms, alcohol intake, number of hospital visits before diagnosis, knowledge of TB, level, and ownership of the health facility of the initial visit. Delay in TB diagnosis is a major challenge in Meru County. There is a need for enhanced health education in the community, strengthening the capacity of private facilities, and empowering healthcare workers on the diagnosis of TB irrespective of how it presents itself.