Delays in health seeking, diagnosis and treatment for tuberculosis patients in Mongolia: an analysis of surveillance data, 2018–2021

Authors

  • Larissa Otero World Health Organization Regional Office for the Western Pacific, Manila, Philippines; Facultad de Medicina, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
  • Tsolmon Boldoo National Tuberculosis Program, Ministry of Health, Ulaanbaatar, Mongolia; World Health Organization Representative Office for Mongolia, Ulaanbaatar, Mongolia
  • Anuzaya Purevdagva World Health Organization Representative Office for Mongolia, Ulaanbaatar, Mongolia
  • Uranchimeg Borgil National Tuberculosis Program, Ministry of Health, Ulaanbaatar, Mongolia
  • Temuulen Enebish National Tuberculosis Program, Ministry of Health, Ulaanbaatar, Mongolia
  • Oyunchimeg Erdenee National Tuberculosis Program, Ministry of Health, Ulaanbaatar, Mongolia
  • Tauhid Islam Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland
  • Fukushi Morishita World Health Organization Regional Office for the Western Pacific, Manila, Philippines

DOI:

https://doi.org/10.5365/wpsar.2024.15.1.1074

Keywords:

tuberculosis, health care seeking behavior, delayed diagnosis, treatment delay, public health surveillance, Mongolia

Abstract

Early diagnosis and treatment of infectious tuberculosis (TB) is essential to the attainment of global targets specified in the End TB Strategy. Using case-based TB surveillance data, we analysed delays in health seeking, diagnosis and treatment among TB patients in Mongolia from 2018 to 2021. We calculated the median and interquartile range (IQR) for “diagnostic delay”, defined as the time from symptom onset to diagnosis, subdivided into “health-seeking delay” (time from symptom onset to first visit to a health facility) and “health facility diagnostic delay” (time from first health facility visit to diagnosis), and for “treatment delay”, defined as the time from diagnosis to start of treatment. We also calculated “total delay”, defined as the time from symptom onset to treatment start. Based on data for 13 968 registered TB patients, the median total delay was estimated to be 37 days (IQR, 19–76). This was mostly due to health-seeking delay (median, 23 days; IQR, 8–53); in contrast, health facility diagnostic delay and treatment delay were relatively short (median, 1 day; IQR, 0–7; median, 1 day; IQR, 0–7, respectively). In 2021, health-seeking delay did not differ significantly between men and women but was shorter in children than in adults and shorter in clinically diagnosed than in bacteriologically confirmed TB cases.
Health-seeking delay was longest in the East region (median, 44.5 days; IQR, 20–87) and shortest in Ulaanbaatar (median, 9; IQR, 14–64). TB treatment delay was similar across sexes, age groups and types of TB diagnosis but slightly longer among retreated cases and people living in Ulaanbaatar. Efforts to reduce TB transmission in Mongolia should prioritize decreasing delays in health seeking.

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Published

21-02-2024

How to Cite

1.
Otero L, Boldoo T, Purevdagva A, Borgil U, Enebish T, Erdenee O, Islam T, Morishita F. Delays in health seeking, diagnosis and treatment for tuberculosis patients in Mongolia: an analysis of surveillance data, 2018–2021. Western Pac Surveill Response J [Internet]. 2024 Feb. 21 [cited 2024 Apr. 20];15(1). Available from: https://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/1074

Issue

Section

Surveillance Report

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