Abstract:

Objective To analyze the trend and influencing factors of pulmonary tuberculosis diagnosis delay in Guangzhou from 2008 to 2018, and to provide scientific evidence for the development of prevention and control policy and measures. Methods Information of 125180 pulmonary tuberculosis cases in Guangzhou from 2008 to 2018 was collected from Tuberculosis Information Management System of China Information System for Disease Control and Prevention, including gender, age, ethnicity, occupation, cases source, cases classification and complication. Influencing factors of pulmonary tuberculosis diagnosis delay were analyzed by univariate and multivariate logistic regression. Results The median of pulmonary tuberculosis patient from seeking medical service to diagnosis was 5 (2, 15) days in Guangzhou from 2008 to 2018, and the rate of the diagnosis delay was 27.43% (34343/125180). Univariate analysis showed that diagnosis delay rates of aged 65-102 (29.70% (4610/15524)), ethnic HAN (27.50% (33829/123013)), occupation as teacher or doctor (33.22% (1320/3974)), health examination (37.86% (1017/2686)) were significantly higher than those aged 25-<45 (26.69% (13585/50894); χ ²=65.253, P<0.001), ethnic minorities (23.72% (514/2167); χ ²=15.291, P<0.001), worker/civilian worker (21.10% (4752/22520); χ ²=879.541, P<0.001), referrals (25.36% (14416/56835); χ ²=570.472, P<0.001), respectively. Multivariate logistic regression analysis showed those with the following characteristics were more likely to be diagnosis delayed: aged 25-<45, 45-<65, 65-102 (aged <25 as reference, OR (95%CI) values were 1.072 (1.033-1.110), 1.136 (1.090-1.184), 1.168 (1.105-1.235), respectively), ethnic HAN (minorities as reference, OR (95%CI)=1.155(1.044-1.278)), children/student, business services, teachers or doctors, farmers, resigned or retired, housekeeping or unemployment, others (worker/civilian worker as reference, OR (95%CI) values were 1.730 (1.617-1.851), 1.784 (1.683-1.890), 1.828 (1.698-1.968), 1.167 (1.111-1.227), 1.632 (1.535-1.736), 1.436 (1.378-1.497), 1.525 (1.462-1.590), respectively), health examination, contact screening, clinical consultation, recommendation, tracing (referrals as reference, OR (95%CI) values were 1.704 (1.572-1.848), 1.531 (1.227-1.910), 1.031 (1.003-1.060), 1.346 (1.192-1.520), 1.535(1.467-1.606), respectively). Conclusion Diagnosis delay of pulmonary tuberculosis cases appears to be increased year by year in Guangzhou from 2008 to 2018. It is necessary to pay more attention to the factors affecting the above diagnosis delay.

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