Abstract:

Objective To analyze the trend and influencing factors of pulmonary tuberculosis (PTB) patient delay in Guangzhou from 2008 to 2018, and to provide scientific evidence for the development of prevention and control measures. Methods Data of 125201 PTB cases registered and treated in Guangzhou from 2008 to 2018 were collected from TB Management Information System of China Information System for Disease Control and Prevention, including residence, gender, age, ethnicity, occupation, cases source, cases classification and complication. Influencing factors of PTB patient delay were analyzed by univariate and multivariate logistic regression. Results Median of days (quartiles) from symptom onset to seeking health care was 13 (2, 38) days in Guangzhou from 2008 to 20l8, with 49.25% (61656/125201) of PTB patients delayed in seeking health care. Univariate analysis showed that patient delay rates of female, aged ≥65, ethnic minorities, children, cases from tracing, extrapulmonary tuberculosis, with complications were significantly higher than those of male (49.98% (19951/39919) vs 48.90% (41705/85282)) (χ ²=12.60, P<0.001), aged <25 (53.60% (8323/15528) vs 43.99% (11493/26129)) (χ ²=664.34, P<0.001), ethnic HAN (52.05% (1128/2167) vs 49.20% (60528/123034)) (χ ²=6.96, P=0.008), teacher or doctor or cadre (64.66% (161/249) vs 46.49% (1848/3975)) (χ ²=878.51, P<0.001), health check (53.06% (5347/10078) vs 23.94% (643/2686)) (χ ²=940.21, P<0.001), PTB (56.27% (3465/6158) vs 48.88% (58191/119043)) (χ ²=127.79, P<0.001) and without complications (63.80% (1202/1884) vs 49.02% (60454/123317)) (χ ²=162.12, P<0.001), respectively. Multivariate logistic regression analysis showed those with the following characteristics were more likely to delay in seeking health care: female (male as reference, OR (95%CI)=1.11 (1.08-1.13)), aged 25-, 45-, ≥65 (aged <25 as reference, OR (95%CI)=1.13 (1.09-1.16), 1.37 (1.32-1.42) and 1.40 (1.33-1.47), respectively), ethnic minorities (ethnic HAN as reference, OR (95%CI)=1.22 (1.12-1.33)), children, worker/civilian worker, farmer, others (teacher or doctor or cadre as reference, OR (95%CI)=2.38 (1.80-3.15), 1.17 (1.10-1.26), 1.38 (1.28-1.48) and 1.17 (1.10-1.25), respectively), clinical consultation, recommendation, referral, tracing (health check as reference, OR (95%CI)=3.06 (2.79-3.35), 3.27 (2.83-3.77), 2.78 (2.54-3.05) and 3.35 (3.04-3.70), respectively), extrapulmonary tuberculosis (pulmonary tuberculosis as reference, OR (95%CI)=1.41 (1.33-1.49)), with complications (without complications as reference, OR (95%CI)=1.62(1.47-1.78)). Conclusion Patient delay is rather common in pulmonary tuberculosis patients in Guangzhou from 2008 to 2018. The influencing factors mentioned above for patient delay should be paid more attention.

Key words: Tuberculosis, Patient delay, Factor analysis,statistical