Abstract: Objective To further analyze the situation of patient delay and the impact factors from TB patients and health service providers in poor rural China, and to provide suggestions to increase TB case detection. Methods 3 poor counties in each of the four provinces, e.g. Fujian, Henan, Liaoning and Xinjiang were selected as study sites. Both quantitative and qualitative Methods were applied to study the patient delay and its impact factors. The study targets included TB patients, health workers and administrators. Patient delay was defined as more than 2 weeks from first symptoms to first visit for doctors. Results Patient delay is rather common in TB patients, with 33.6% TB patients delayed in seeking health care. The factors impacted delay from TB patients and health service providers include:(1) Lack of TB knowledge is common among general population in rural area;(2)Health promotion activities conducted by health providers are not enough. Conclusion Patient delay is rather common in poor rural area in China. TB awareness should be improved by targeted health promotion activities. Integrated measures should be taken to change the health care seeking behaviors among the rural population .

Key words: Pulmonary tuberculosis/diagnosis