Tuberculosis diagnostic delay and its correlates among patients hospitalized during the COVID-19 pandemic period at a tertiary public hospital in Nairobi, Kenya

Abstract

Background: Tuberculosis (TB) diagnostic delay remains a core challenge in the achievement of effective TB prevention and control globally. A study was undertaken to determine TB diagnostic delay and its correlates among patients hospitalized during the COVID -19 pandemic period at a tertiary public hospital in Nairobi, Kenya Methods: This was a cross sectional mixed parallel method study conducted at Kenyatta National Hospital. Quantitatively, hospitalized patients’ records from January 2020 to December 2021 were abstracted while qualitatively in-depth telephone interviews were conducted on 36 discharged patients. Diagnostic delay was defined as time from admission until diagnosis (>5 days). Logistic regression was used to determine the factors associated with diagnostic delay while qualitative data was thematically organized using N-Vivo software version 12. Results: A total of 563 (67.1%) delayed in being diagnosed for TB. Extrapulmonary TB (EPTB) aOR=4.108 (95% CI 2.782–6.067), and GeneXpert test aOR=6.306 (95% CI 3.763–10.568), p=0.000 were significantly associated with delayed TB diagnosis. On their pathway to final diagnosis, hospitalized patients encountered personal, private and lower public facilities’ barriers during the COVID-19 period. Conclusion: TB diagnostic delay worsened during the COVID-19 pandemic period. Effective utilization of TB dedicated diagnostic tools and efficient public private partnerships can reduce TB diagnostic delay in case of any future pandemics.