Figure 1
Selection of presumptive tuberculosis episodes.
Table 1
Demographic and clinical characteristics of people with presumptive tuberculosis, 2025.
| CHARACTERISTIC | TOTAL, N (%) | MALE, N (%) | FEMALE, N (%) | P VALUE |
|---|---|---|---|---|
| Total | 503 (100.0) | 282 (56.1) | 221 (43.9) | |
| Age, median (IQR), years | 42 (27–58) | 45 (30–60) | 39 (24–55) | 0.018 |
| 0–14 years | 48 (9.5) | 25 (8.9) | 23 (10.4) | |
| 15–24 years | 72 (14.3) | 36 (12.8) | 36 (16.3) | |
| 25–44 years | 147 (29.2) | 78 (27.7) | 69 (31.2) | |
| 45–64 years | 158 (31.4) | 95 (33.7) | 63 (28.5) | |
| >=65 years | 78 (15.5) | 48 (17.0) | 30 (13.6) | 0.041 |
| Pulmonary disease | 438 (87.1) | 250 (88.7) | 188 (85.1) | |
| Extrapulmonary disease | 65 (12.9) | 32 (11.3) | 33 (14.9) | 0.214 |
| Self‑presenting | 226 (44.9) | 137 (48.6) | 89 (40.3) | |
| Community cadre referral | 137 (27.2) | 70 (24.8) | 67 (30.3) | |
| Other health facility referral | 96 (19.1) | 52 (18.4) | 44 (19.9) | |
| Private provider referral | 44 (8.7) | 23 (8.2) | 21 (9.5) | 0.032 |
| Diabetes mellitus recorded | 67 (13.3) | 42 (14.9) | 25 (11.3) | 0.236 |
| Inside catchment area | 421 (83.7) | 238 (84.4) | 183 (82.8) | 0.638 |
[i] IQR = interquartile range. Percentages use column denominators unless otherwise indicated. P values compare male and female participants using Mann‑Whitney U, chi‑square, or Fisher exact tests.
Table 2
Diagnostic delay by demographic and clinical characteristics.
| CHARACTERISTIC | N | MEDIAN DAYS (IQR) | >14 DAYS, N (%) | >30 DAYS, N (%) | P VALUE |
|---|---|---|---|---|---|
| Total | 486 | 4 (1–11) | 94 (19.3) | 37 (7.6) | |
| Male | 273 | 5 (1–12) | 58 (21.2) | 24 (8.8) | |
| Female | 213 | 3 (1–9) | 36 (16.9) | 13 (6.1) | 0.086 |
| 0–14 years | 46 | 2 (0–7) | 5 (10.9) | 2 (4.3) | |
| 15–24 years | 69 | 3 (1–8) | 9 (13.0) | 3 (4.3) | |
| 25–44 years | 143 | 4 (1–10) | 24 (16.8) | 8 (5.6) | |
| 45–64 years | 153 | 5 (2–13) | 35 (22.9) | 15 (9.8) | |
| >=65 years | 75 | 7 (2–16) | 21 (28.0) | 9 (12.0) | 0.011 |
| Pulmonary disease | 424 | 4 (1–10) | 75 (17.7) | 27 (6.4) | |
| Extrapulmonary disease | 62 | 8 (3–18) | 19 (30.6) | 10 (16.1) | 0.004 |
| Self‑presenting | 219 | 3 (1–8) | 31 (14.2) | 10 (4.6) | |
| Community cadre referral | 133 | 4 (1–10) | 24 (18.0) | 8 (6.0) | |
| Other health facility referral | 92 | 7 (2–16) | 25 (27.2) | 12 (13.0) | |
| Private provider referral | 42 | 8 (3–19) | 14 (33.3) | 7 (16.7) | 0.002 |
[i] IQR = interquartile range. Diagnostic delay was measured from presumptive tuberculosis registration to the first recorded diagnostic result. P values compare subgroup distributions of delay.
Table 3
Negative binomial regression analysis of factors associated with diagnostic delay (n = 486).
| VARIABLE | CRUDE IRR | 95% CI | P VALUE | ADJUSTED IRR* | 95% CI | P VALUE |
|---|---|---|---|---|---|---|
| Sex | ||||||
| Male | 1.18 | 0.98–1.42 | 0.081 | 1.12 | 0.93–1.36 | 0.229 |
| Female | Reference | – | – | Reference | – | – |
| Age group (years) | ||||||
| 0–14 | 0.74 | 0.51–1.08 | 0.119 | 0.78 | 0.53–1.15 | 0.205 |
| 15–24 | 0.82 | 0.61–1.10 | 0.184 | 0.85 | 0.63–1.15 | 0.292 |
| 25–44 | Reference | – | – | Reference | – | – |
| 45–64 | 1.24 | 1.01–1.53 | 0.044 | 1.21 | 0.98–1.50 | 0.077 |
| ≥65 | 1.53 | 1.18–1.98 | 0.001 | 1.46 | 1.12–1.90 | 0.005 |
| Anatomical disease site | ||||||
| Extrapulmonary disease | 1.71 | 1.33–2.20 | <0.001 | 1.58 | 1.21–2.07 | 0.001 |
| Pulmonary disease | Reference | – | – | Reference | – | – |
| Referral source | ||||||
| Community cadre referral | 1.18 | 0.91–1.52 | 0.210 | 1.13 | 0.87–1.47 | 0.360 |
| Other health facility referral | 1.49 | 1.12–1.98 | 0.006 | 1.35 | 1.01–1.82 | 0.045 |
| Private provider referral | 1.67 | 1.15–2.43 | 0.007 | 1.44 | 0.98–2.11 | 0.064 |
| Self‑presenting | Reference | – | – | Reference | – | – |
[i] Adjusted for age group, sex, anatomical disease site, referral source, diabetes mellitus status, and residential area. Negative binomial regression was used because diagnostic delay (days) was a count outcome with evidence of overdispersion. Diagnostic delay was defined as the interval between presumptive tuberculosis registration and the first recorded diagnostic result.
Table 4
Adjusted logistic regression analysis of prolonged diagnostic delay (n = 486).
| VARIABLE | >14‑DAY DELAY aOR* | 95% CI | P VALUE | >30‑DAY DELAY aOR* | 95% CI | P VALUE |
|---|---|---|---|---|---|---|
| Sex | ||||||
| Male | 1.19 | 0.74–1.92 | 0.473 | 1.31 | 0.66–2.61 | 0.438 |
| Female | Reference | – | – | Reference | – | – |
| Age group (years) | ||||||
| 0–14 | 0.64 | 0.23–1.79 | 0.394 | 0.77 | 0.16–3.70 | 0.742 |
| 15–24 | 0.73 | 0.31–1.71 | 0.468 | 0.75 | 0.19–2.91 | 0.674 |
| 25–44 | Reference | – | – | Reference | – | – |
| 45–64 | 1.42 | 0.80–2.52 | 0.229 | 1.58 | 0.67–3.71 | 0.296 |
| ≥65 | 1.88 | 1.02–3.47 | 0.043 | 2.03 | 0.82–5.03 | 0.126 |
| Anatomical disease site | ||||||
| Extrapulmonary disease | 2.14 | 1.15–3.98 | 0.016 | 2.63 | 1.16–5.95 | 0.020 |
| Pulmonary disease | Reference | – | – | Reference | – | – |
| Referral source | ||||||
| Community cadre referral | 1.22 | 0.69–2.16 | 0.494 | 1.18 | 0.46–3.00 | 0.730 |
| Other health facility referral | 1.86 | 1.03–3.35 | 0.039 | 2.21 | 0.94–5.22 | 0.069 |
| Private provider referral | 2.09 | 0.98–4.45 | 0.056 | 2.47 | 0.86–7.08 | 0.094 |
| Self‑presenting | Reference | – | – | Reference | – | – |
[i] Abbreviations: aOR, adjusted odds ratio; CI, confidence interval.
[ii] Multivariable logistic regression models were used to evaluate factors associated with prolonged diagnostic delay. The primary analysis defined prolonged delay as >14 days, while a >30‑day threshold was examined in sensitivity analyses. Models were adjusted for age group, sex, anatomical disease site, referral source, diabetes mellitus status, and residential area. Reference categories were female sex, age 25–44 years, pulmonary disease, and self‑presentation.
Table 5
Distribution of tuberculosis diagnostic outcomes and treatment initiation.
| OUTCOME | N (%) |
|---|---|
| Among all presumptive tuberculosis episodes (n = 503) | |
| Tuberculosis diagnosis | 176 (35.0) |
| Not tuberculosis | 295 (58.6) |
| Inconclusive or unknown | 32 (6.4) |
| Among diagnosed tuberculosis cases (n = 176) | |
| Bacteriologically confirmed drug‑susceptible tuberculosis | 118 (67.0) |
| Bacteriologically confirmed drug‑resistant tuberculosis | 9 (5.1) |
| Clinically diagnosed tuberculosis | 49 (27.8) |
| Treatment initiation among diagnosed patients (n = 176) | |
| Treatment initiation documented | 158 (89.8) |
| No documented treatment initiation | 18 (10.2) |
[i] Abbreviation: TB, tuberculosis.
Table 6
Predictors of tuberculosis diagnosis.
| VARIABLE | ADJUSTED OR | 95% CI | P VALUE |
|---|---|---|---|
| Male sex | 1.39 | 0.96–2.01 | 0.081 |
| Extrapulmonary disease | 0.58 | 0.32–0.96 | 0.035 |
Table 7
Predictors of treatment initiation among patients diagnosed with tuberculosis (n = 176).
| VARIABLE | ADJUSTED OR | 95% CI | P VALUE |
|---|---|---|---|
| Male sex | 0.83 | 0.30–2.27 | 0.713 |
| Diagnostic delay >14 days | 0.46 | 0.16–1.35 | 0.158 |
[i] Abbreviations: OR, odds ratio; CI, confidence interval.
[ii] Note: Models were adjusted for age group, sex, anatomical disease site, referral source, diabetes mellitus status, and residential area, as appropriate. The treatment initiation model was restricted to participants with a confirmed tuberculosis diagnosis (n = 176).