Paper Title
Factors Associated With Delays Of Treatment Among Aids Patients With New Smear- Positive Pulmonary Tuberculosis In Nakhon Phanom Province

Abstract
AIDS with tuberculosis-infected patients remain the major problem in public health because the delays of treatment can affect the severity and the transmission of disease. This research aimed to determine the prevalence of treatment delays and the factors associated with delays of treatment among AIDS Patients with new smear-positive pulmonary tuberculosis. A cross-sectional study was conducted among AIDS patients with new smear-positive pulmonary tuberculosis registered in 11 tuberculosis clinics in Nakhon Phanom province hospital. The study was conducted between January 2013 and February 2014. Data were collected by face-to-face interviews with structured questionnaires and from copies of the patientsí medical records. The simple logistic regression was used, and a multiple logistic regression analysis was performed to compute adjusted odds ratios with 95% CI. In a total of 319 new smear-positive pulmonary tuberculosis patients, 31.3% (95%CI = 1.26-1.37) experienced patient were delays longer than 30 days. The factors significantly associated with patient delay were female gender (ORadj = 2.64, 95%CI = 1.33-5.16), age less than 50 years old (ORadj = 2.24, 95%CI = 1.18-4.22), a smoking history (ORadj= 3.18, 95%CI = 1.66-6.15), never having received information from village health volunteers and community leaders (ORadj= 2.66, 95%CI= 1.35-4.82), a monthly income (ORadj= 2.46, 95%CI= 1.32-4.65), number of people in households (ORadj= 2.47, 95%CI= 1.45-4.27), and unsuspected TB infection (ORadj= 1.89, 95%CI= 1.27-3.89). Factors significantly associated with health system delays were more than three sputum examinations (ORadj= 10.29, 95%CI= 3.27-34.14), the initial diagnosis of some other complication disease (ORadj= 9.45, 95%CI= 2.56-33.34), and no chest x-ray (ORadj= 5.93, 95%CI= 1.82-19.29). Therefore, health services for AIDS patients with tuberculosis need to be more proactive in terms of health education. Also, there needs to be more collaboration between health volunteers and community leaders in drawing attention to these issues. Keyword- AIDS, AIDS Patients With Tuberculosis, Delays Of Treatment.