Factors Related to the Delay in Diagnosis and Treatment of Pulmonary Tuberculosis in the Territory of Malemba Nkulu, Haut Lomami Province in the Democratic Republic of the Congo

Introduction: The territory of Malemba Nkulu experiences the highest rates of pulmonary tuberculosis detection in the country.This rate exceeds the detection rate for the entire Haut Lomami province for pulmonary tuberculosis, surpasses the national average detection rate, and the estimated detection rate by the WHO for the Democratic Republic of the Congo.The aim of this study was to determine the patient delay and the health system delay, as well as to identify the factors associated with these delays.Methods: A cross-sectional study was conducted, and a semi-structured questionnaire, along with documentation referring to the patients' medical records, served as our data collection tools.We collected data from 786 pulmonary tuberculosis patients with positive microscopy attending the diagnosis and treatment health centers (DTHC) in the four health districts of the Malemba territory, Haut Lomami province.We investigated the patient delay and the health system delay, and we also identified the factors related to these delays.The study covered a period from January to December 2022.The response rate was 47.6%, meaning 374 patients agreed to answer our questionnaire out of 786 selected.The data were analyzed using Epi Info version 7. Results: We found in these patients the median values of patient delay, health system delay, and total delay, which were respectively 62 days, 2 days, and 64 days.Two hundred fifty-eight patients (69%) consulted traditional or spiritual healers before seeking regular medical care.This group of patients experienced a median delay of 121 days, while one hundred sixteen patients