Factors Affecting the Initiation of Tuberculosis Treatment in Patients with Pulmonary Tuberculosis at Thungsong Hospital

Abstract

Pulmonary tuberculosis diagnosis remains challenging issues at Thungsong Hospital, where diagnostic practice primarily relies on clinical history, chest radiography, and confirmation by acid-fast bacilli (AFB) smear microscopy. This study aimed to identify factors associated with initiation of pulmonary tuberculosis treatment within 3 working days after patients presented for care. A retrospective cross-sectional study was conducted using medical records of 180 registered pulmonary tuberculosis patients treated between 2021 and 2023. Associations between demographic characteristics, clinical manifestations, AFB smear results, Xpert MTB/RIF molecular assay results, chest radiographic findings, and internists’ decisions to initiate treatment were analyzed in relation to time to treatment initiation. Descriptive statistics, Fisher's exact test, and logistic regression analysis were applied.

Of the 180 patients, 76 (42.22%) initiated treatment within 3 days, whereas 104 (57.78%) started treatment after 3 days. Positive AFB smear results and diagnosis by an internist were significantly associated with treatment initiation within 3 days (p < 0.05). In contrast, clinical symptoms and chest radiographic findings were not significantly associated with early treatment initiation.

These findings indicate that rapid laboratory confirmation and physician confidence in clinical decision-making play crucial roles in timely initiation of anti-tuberculosis therapy, which is essential for reducing disease transmission and supporting the End TB Strategy of the World Health Organization.