It is important that people with TB start treatment as soon as possible but in many countries long delays are common between the onset of symptoms and the commencement of the recommended DOTS treatment. A research team in Indonesia examined the factors that might be responsible for delays.
They documented healthcare utilization pattern of smear positive TB patients prior to diagnosis and treatment by DOTS services in Yogyakarta province. The median delay between symptom onset and treatment was 8 weeks in urban areas and 12 for patients in the rural areas. Multivariate analysis suggested no confounding between individual factors and urban-rural setting remained as the main factor for total delay.
While there are many steps which could be take to reduce treatment delay, in this setting at least the most crucial need is to improve access to treatment services in the rural areas. The study, in BMC Public Health, may be read here.