Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis

Kenaw Tegegne Tefera; Fasil Wagnew; Yihalem Abebe Belay; Dawit Eyayu; Daniel Bekele Ketema

doi:doi:10.11648/j.ajlm.20210604.11

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Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis

Kenaw Tegegne Tefera, Fasil Wagnew, Yihalem Abebe Belay, Dawit Eyayu, Daniel Bekele Ketema

Published in American Journal of Laboratory Medicine (Volume 6, Issue 4)

Received: 10 May 2021 Accepted: 5 July 2021 Published: 13 July 2021

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Abstract

Delay in diagnosis and initiation of effective treatment associated with an increase in morbidity, mortality, and ongoing person-to-person transmission in the community at large. Several studies have been conducted in Ethiopia; however, studies assessing the health system's delay in treating tuberculosis patients have yielded inconsistent and inconclusive results. Therefore, this systematic review and meta-analysis aimed to determine the pooled median time of the health system delay in the treatment of tuberculosis and its determinants in Ethiopia. We systematically searched different databases: Google Scholar, Science Direct, PubMed, Embase, Scopus, and Springer link databases for studies published from June 6,1997 up to December 20, 2020. The quality of the studies was assessed using the Newcastle-Ottawa scale adapted for observational studies. We conducted a meta-analysis for the pooled median time of health system delay and its determinants using a random-effects model in R version 4.0.3 software (for median estimation) and Stata version 14 (for metan). A total of 14 studies with 6161 patients who met predetermined criteria were included. Our meta-analysis showed that the estimated pooled median time of the health system delay was 15.29 (95%CI: 9.94–20.64) days. In the subgroup analysis, studies conducted from 1997 to 2015, the pooled median health system delay was 21.63 (95% CI: 14.38-28.88) days, whereas in studies conducted after 2015, the pooled median time was 9.33 (95% CI: 3.95-14.70) days. Living in rural areas (pooled OR: 2.42, 95%CI: 1.16-5.02) was significantly associated with health system delay. In Ethiopia, this review highlights that patients were delayed more than two weeks in the treatment of tuberculosis. Being a rural resident, was the contributing factor of health system delay. For successful TB control, implementing efforts like providing regular health education to the community about TB emphasizes the rural community and enhancing the quality of care in TB treatment facilities in rural areas could have important implications to reduce health system delay.

Published in	American Journal of Laboratory Medicine (Volume 6, Issue 4)
DOI	10.11648/j.ajlm.20210604.11
Page(s)	42-57
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Health System Delay, Median, Meta-analysis, Tuberculosis, Ethiopia

References

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Kenaw Tegegne Tefera, Fasil Wagnew, Yihalem Abebe Belay, Dawit Eyayu, Daniel Bekele Ketema. (2021). Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis. American Journal of Laboratory Medicine, 6(4), 42-57. https://doi.org/10.11648/j.ajlm.20210604.11

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ACS Style

Kenaw Tegegne Tefera; Fasil Wagnew; Yihalem Abebe Belay; Dawit Eyayu; Daniel Bekele Ketema. Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis. Am. J. Lab. Med. 2021, 6(4), 42-57. doi: 10.11648/j.ajlm.20210604.11

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AMA Style

Kenaw Tegegne Tefera, Fasil Wagnew, Yihalem Abebe Belay, Dawit Eyayu, Daniel Bekele Ketema. Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis. Am J Lab Med. 2021;6(4):42-57. doi: 10.11648/j.ajlm.20210604.11

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@article{10.11648/j.ajlm.20210604.11,
  author = {Kenaw Tegegne Tefera and Fasil Wagnew and Yihalem Abebe Belay and Dawit Eyayu and Daniel Bekele Ketema},
  title = {Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis},
  journal = {American Journal of Laboratory Medicine},
  volume = {6},
  number = {4},
  pages = {42-57},
  doi = {10.11648/j.ajlm.20210604.11},
  url = {https://doi.org/10.11648/j.ajlm.20210604.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20210604.11},
  abstract = {Delay in diagnosis and initiation of effective treatment associated with an increase in morbidity, mortality, and ongoing person-to-person transmission in the community at large. Several studies have been conducted in Ethiopia; however, studies assessing the health system's delay in treating tuberculosis patients have yielded inconsistent and inconclusive results. Therefore, this systematic review and meta-analysis aimed to determine the pooled median time of the health system delay in the treatment of tuberculosis and its determinants in Ethiopia. We systematically searched different databases: Google Scholar, Science Direct, PubMed, Embase, Scopus, and Springer link databases for studies published from June 6,1997 up to December 20, 2020. The quality of the studies was assessed using the Newcastle-Ottawa scale adapted for observational studies. We conducted a meta-analysis for the pooled median time of health system delay and its determinants using a random-effects model in R version 4.0.3 software (for median estimation) and Stata version 14 (for metan). A total of 14 studies with 6161 patients who met predetermined criteria were included. Our meta-analysis showed that the estimated pooled median time of the health system delay was 15.29 (95%CI: 9.94–20.64) days. In the subgroup analysis, studies conducted from 1997 to 2015, the pooled median health system delay was 21.63 (95% CI: 14.38-28.88) days, whereas in studies conducted after 2015, the pooled median time was 9.33 (95% CI: 3.95-14.70) days. Living in rural areas (pooled OR: 2.42, 95%CI: 1.16-5.02) was significantly associated with health system delay. In Ethiopia, this review highlights that patients were delayed more than two weeks in the treatment of tuberculosis. Being a rural resident, was the contributing factor of health system delay. For successful TB control, implementing efforts like providing regular health education to the community about TB emphasizes the rural community and enhancing the quality of care in TB treatment facilities in rural areas could have important implications to reduce health system delay.},
 year = {2021}
}

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TY  - JOUR
T1  - Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis
AU  - Kenaw Tegegne Tefera
AU  - Fasil Wagnew
AU  - Yihalem Abebe Belay
AU  - Dawit Eyayu
AU  - Daniel Bekele Ketema
Y1  - 2021/07/13
PY  - 2021
N1  - https://doi.org/10.11648/j.ajlm.20210604.11
DO  - 10.11648/j.ajlm.20210604.11
T2  - American Journal of Laboratory Medicine
JF  - American Journal of Laboratory Medicine
JO  - American Journal of Laboratory Medicine
SP  - 42
EP  - 57
PB  - Science Publishing Group
SN  - 2575-386X
UR  - https://doi.org/10.11648/j.ajlm.20210604.11
AB  - Delay in diagnosis and initiation of effective treatment associated with an increase in morbidity, mortality, and ongoing person-to-person transmission in the community at large. Several studies have been conducted in Ethiopia; however, studies assessing the health system's delay in treating tuberculosis patients have yielded inconsistent and inconclusive results. Therefore, this systematic review and meta-analysis aimed to determine the pooled median time of the health system delay in the treatment of tuberculosis and its determinants in Ethiopia. We systematically searched different databases: Google Scholar, Science Direct, PubMed, Embase, Scopus, and Springer link databases for studies published from June 6,1997 up to December 20, 2020. The quality of the studies was assessed using the Newcastle-Ottawa scale adapted for observational studies. We conducted a meta-analysis for the pooled median time of health system delay and its determinants using a random-effects model in R version 4.0.3 software (for median estimation) and Stata version 14 (for metan). A total of 14 studies with 6161 patients who met predetermined criteria were included. Our meta-analysis showed that the estimated pooled median time of the health system delay was 15.29 (95%CI: 9.94–20.64) days. In the subgroup analysis, studies conducted from 1997 to 2015, the pooled median health system delay was 21.63 (95% CI: 14.38-28.88) days, whereas in studies conducted after 2015, the pooled median time was 9.33 (95% CI: 3.95-14.70) days. Living in rural areas (pooled OR: 2.42, 95%CI: 1.16-5.02) was significantly associated with health system delay. In Ethiopia, this review highlights that patients were delayed more than two weeks in the treatment of tuberculosis. Being a rural resident, was the contributing factor of health system delay. For successful TB control, implementing efforts like providing regular health education to the community about TB emphasizes the rural community and enhancing the quality of care in TB treatment facilities in rural areas could have important implications to reduce health system delay.
VL  - 6
IS  - 4
ER  -

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Author Information

Kenaw Tegegne Tefera

Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
Fasil Wagnew

Department of Pediatrics and Child Health Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
Yihalem Abebe Belay

Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
Dawit Eyayu

Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
Daniel Bekele Ketema

Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia

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APA Style

Kenaw Tegegne Tefera, Fasil Wagnew, Yihalem Abebe Belay, Dawit Eyayu, Daniel Bekele Ketema. (2021). Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis. American Journal of Laboratory Medicine, 6(4), 42-57. https://doi.org/10.11648/j.ajlm.20210604.11

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ACS Style

Kenaw Tegegne Tefera; Fasil Wagnew; Yihalem Abebe Belay; Dawit Eyayu; Daniel Bekele Ketema. Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis. Am. J. Lab. Med. 2021, 6(4), 42-57. doi: 10.11648/j.ajlm.20210604.11

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AMA Style

Kenaw Tegegne Tefera, Fasil Wagnew, Yihalem Abebe Belay, Dawit Eyayu, Daniel Bekele Ketema. Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis. Am J Lab Med. 2021;6(4):42-57. doi: 10.11648/j.ajlm.20210604.11

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@article{10.11648/j.ajlm.20210604.11,
  author = {Kenaw Tegegne Tefera and Fasil Wagnew and Yihalem Abebe Belay and Dawit Eyayu and Daniel Bekele Ketema},
  title = {Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis},
  journal = {American Journal of Laboratory Medicine},
  volume = {6},
  number = {4},
  pages = {42-57},
  doi = {10.11648/j.ajlm.20210604.11},
  url = {https://doi.org/10.11648/j.ajlm.20210604.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20210604.11},
  abstract = {Delay in diagnosis and initiation of effective treatment associated with an increase in morbidity, mortality, and ongoing person-to-person transmission in the community at large. Several studies have been conducted in Ethiopia; however, studies assessing the health system's delay in treating tuberculosis patients have yielded inconsistent and inconclusive results. Therefore, this systematic review and meta-analysis aimed to determine the pooled median time of the health system delay in the treatment of tuberculosis and its determinants in Ethiopia. We systematically searched different databases: Google Scholar, Science Direct, PubMed, Embase, Scopus, and Springer link databases for studies published from June 6,1997 up to December 20, 2020. The quality of the studies was assessed using the Newcastle-Ottawa scale adapted for observational studies. We conducted a meta-analysis for the pooled median time of health system delay and its determinants using a random-effects model in R version 4.0.3 software (for median estimation) and Stata version 14 (for metan). A total of 14 studies with 6161 patients who met predetermined criteria were included. Our meta-analysis showed that the estimated pooled median time of the health system delay was 15.29 (95%CI: 9.94–20.64) days. In the subgroup analysis, studies conducted from 1997 to 2015, the pooled median health system delay was 21.63 (95% CI: 14.38-28.88) days, whereas in studies conducted after 2015, the pooled median time was 9.33 (95% CI: 3.95-14.70) days. Living in rural areas (pooled OR: 2.42, 95%CI: 1.16-5.02) was significantly associated with health system delay. In Ethiopia, this review highlights that patients were delayed more than two weeks in the treatment of tuberculosis. Being a rural resident, was the contributing factor of health system delay. For successful TB control, implementing efforts like providing regular health education to the community about TB emphasizes the rural community and enhancing the quality of care in TB treatment facilities in rural areas could have important implications to reduce health system delay.},
 year = {2021}
}

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TY  - JOUR
T1  - Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis
AU  - Kenaw Tegegne Tefera
AU  - Fasil Wagnew
AU  - Yihalem Abebe Belay
AU  - Dawit Eyayu
AU  - Daniel Bekele Ketema
Y1  - 2021/07/13
PY  - 2021
N1  - https://doi.org/10.11648/j.ajlm.20210604.11
DO  - 10.11648/j.ajlm.20210604.11
T2  - American Journal of Laboratory Medicine
JF  - American Journal of Laboratory Medicine
JO  - American Journal of Laboratory Medicine
SP  - 42
EP  - 57
PB  - Science Publishing Group
SN  - 2575-386X
UR  - https://doi.org/10.11648/j.ajlm.20210604.11
AB  - Delay in diagnosis and initiation of effective treatment associated with an increase in morbidity, mortality, and ongoing person-to-person transmission in the community at large. Several studies have been conducted in Ethiopia; however, studies assessing the health system's delay in treating tuberculosis patients have yielded inconsistent and inconclusive results. Therefore, this systematic review and meta-analysis aimed to determine the pooled median time of the health system delay in the treatment of tuberculosis and its determinants in Ethiopia. We systematically searched different databases: Google Scholar, Science Direct, PubMed, Embase, Scopus, and Springer link databases for studies published from June 6,1997 up to December 20, 2020. The quality of the studies was assessed using the Newcastle-Ottawa scale adapted for observational studies. We conducted a meta-analysis for the pooled median time of health system delay and its determinants using a random-effects model in R version 4.0.3 software (for median estimation) and Stata version 14 (for metan). A total of 14 studies with 6161 patients who met predetermined criteria were included. Our meta-analysis showed that the estimated pooled median time of the health system delay was 15.29 (95%CI: 9.94–20.64) days. In the subgroup analysis, studies conducted from 1997 to 2015, the pooled median health system delay was 21.63 (95% CI: 14.38-28.88) days, whereas in studies conducted after 2015, the pooled median time was 9.33 (95% CI: 3.95-14.70) days. Living in rural areas (pooled OR: 2.42, 95%CI: 1.16-5.02) was significantly associated with health system delay. In Ethiopia, this review highlights that patients were delayed more than two weeks in the treatment of tuberculosis. Being a rural resident, was the contributing factor of health system delay. For successful TB control, implementing efforts like providing regular health education to the community about TB emphasizes the rural community and enhancing the quality of care in TB treatment facilities in rural areas could have important implications to reduce health system delay.
VL  - 6
IS  - 4
ER  -

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