A Short Narrative Review on the Delays in Tuberculosis Care in Odisha

Early diagnosis and prompt treatment are definite steps toward tuberculosis (TB) elimination efforts; however, the same is greatly affected by delays in the TB care cascade. The delay, on the other hand, depends on the factors related to both sides of the health system, the supply and the demand side or the patient and the health system side. A review was carried out to understand different types, durations, and factors associated with delays in TB care among different population groups in Odisha. PubMed and Google Scholar search engines were used for searching relevant literature using the search string "Tuberculosis" AND "Delay" AND "Odisha." Additionally, articles from cross-references were selected, with final inclusion of four studies for this review. Of the four studies, two articles each are based on secondary research and primary research. The secondary researches are based on Nikshay portal data, and primary researches are cross-sectional studies. Two studies were conducted in the tribal district of Rayagada, and one each included a sample from Cuttack to Mayurbhanj, with one pan-Odisha study. The retrospective observational registry-based cohort study among 47,831 TB cases across the state reported that 7.6% of cases were initiated on treatment after 14 days of diagnosis. The retrospective cohort study conducted in Cuttack and Rayagada district reported treatment delay of >15 days among 20% of the cases and median delay of treatment initiation of 14 days. The cross-sectional study in Rayagada reported that 62.2% of the patients reported to the designated microscopic centers (DMCs) after a month of the onset of symptoms. During recent days, the situation has improved; however, efforts must be directed toward improving knowledge and awareness about TB and its services among the tribal population, thereby improving health-seeking behavior and reducing delays.