Abstract:

Objective: This study aims to evaluate the willingness to accept pulmonary tuberculosis (PTB) screening and its influencing factors under the active screening strategy for PTB among the elderly (aged 65 and above) in ethnic minority areas of Yunnan Province, and to provide suggestions for improving quality of active screening in the future. Methods: From January 1 to December 31, 2023, a stratified random sampling questionnaire survey was conducted on the willingness to accept active PTB screening among the elderly aged 65 and above in 12 towns/communities of 6 counties (cities) in 3 ethnic areas of Yunnan Province. A total of 1399 pieces of questionnaire were distributed, and 1395 valid pieces were retrieved, with a valid rate of 99.71%. Results: 92.62% (1292/1395) of the elderly were willing to take PTB symptom screening, 94.27% (1315/1395) were willing to undergo PTB-related examinations, and 90.18% (1258/1395) were willing to accept both. The willingness to accept active PTB screening was presented as follows: The willingness of non-farmers to accept active screening was 9.157 (95%CI: 1.242-67.495) times of that of farmers. The willingness of those who purchased other medical insurance for active screening was 4.098 times of that of those who purchased the medical insurance for urban and rural residents (95%CI: 1.762-9.531). Individuals with at least one disease had a willingness to be screened that was 1.767 (95%CI: 1.198-2.604) times of that of individuals with no diseases. Those who knew that “the elderly are more prone to tuberculosis” had 3.110 (95%CI: 2.101-4.603) times of willingness to actively undergo screening compared with those who were unaware. The willingness for active screening of families with annual per capita medical expenditure less than OR equal to the average level was lower than that of families with annual per capita medical expenditure greater than the average level (OR=0.459, 95%CI: 0.313-0.674). Conclusion: Under the current policy, the willingness of the elderly aged 65 and above in ethnic minority areas of Yunnan Province to undergo active PTB screening is high. Active PTB screening among the elderly should continue to be carried out in combination with The National Basic Public Health Service Project to improve the quality and efficiency of screening and thereby improve the level of patient detection.

Key words: Aged, Tuberculosis, Active screening, Questionnaires, Factor analysis, statistical