Delay and completion of tuberculosis treatment: a cross-sectional study in the West Midlands, UK

TB remains a significant problem in the UK with the West Midlands having the highest incidence after London. Treatment is usually for a minimum of 6 months and requires a high level of compliance. We investigated potential determinants of delays and completion of treatment for tuberculosis (TB) in the West Midlands, UK. We used data on 4840 patients with TB in the West Midlands from the Enhanced Tuberculosis Surveillance database from 1 January 2005 to 1 October 2010. We used regression models to investigate the cross-sectional association between sociodemographic and clinical risk factors and the timeliness and completion of TB treatment. Patients with TB waited 82 days on average from symptom onset to treatment initiation. Female patients spent 6 longer time than males before receiving treatment [95 confidence interval (CI): 1.211.6, P 0.015]. Asian/Asian British patients were 11 times more likely to complete treatment than White patients (adjusted odds ratio: 11.4, 95 CI: 1.31100.3, P 0.028). Females in the West Midlands took longer time to receive TB treatment than males, representing a health inequality that could be addressed through gender-sensitive awareness raising programmes. White patients were less likely to complete treatment than Asian/Asian British patients; additional support is needed in this group.