Exploring Barriers to Timely Diagnosis and Treatment of Tuberculosis in Selangor, Malaysia: A Qualitative Study

Tuberculosis (TB) occurs as one of the highest in the state of Selangor, Malaysia and its causes are currently underexplored especially from patients' perspectives of the disease. This study assesses perspectives from patients in relations to determinants of delayed presentation, diagnosis, and treatment of TB. The study utilises a qualitative methodology involving focus group discussions and in-depth interviews with patients selected based on specific inclusion and exclusion criteria. The research covered components which include social demographic, sociocultural factors, health-seeking behaviors, social support and resources, previous knowledge and experience as a TB patient, and treatment pathway. Thematic analysis was performed using NVivo 12 analysis software to interpret the data. This study aims to identify key barriers and facilitators of prompt presentation and diagnosis of TB patients. Results revealed that socioeconomic status, challenges faced during TB diagnosis and treatment, knowledge of TB, patient and healthcare-related factors, and health-seeking behaviours were the main emerging themes. Improvements are required in the areas of access to healthcare facilities, minimizing cost, providing specific clinics and proximity of health facilities to facilitate a prompt response, increasing capacity to isolate infected persons, and provision of adequate treatment. It is revealed that financial constraints, inaccessibility and long distance to healthcare facilities, poor knowledge of TB, and lack of family and social support contributed to delayed TB presentation and diagnosis. Findings from this study can be utilized to develop effective, locally tailored interventions to address delayed presentation and diagnosis of TB patients in the nation.