Abstract:

Objective: To analyze the current status and influencing factors of diagnosis and treatment delays in patients with rifampicin-resistant tuberculosis (RR-TB) in China in 2021, in order to provide evidence for optimizing the diagnosis and treatment process for drug-resistant tuberculosis. Methods: A cross-sectional study was conducted to collect the data of rifampicin-resistant TB patients registered in the “China Disease Prevention and Control Information System” from January 2021 to December 2021. After completeness and logic cleaning, a total of 9025 patients were ultimately included in the analysis. The distribution of patients’ diagnosis and treatment time was described using median (quartile). Non-parametric rank-sum tests were used to compare differences between groups, and multivariate logistic regression analysis was employed to identify factors influencing delays in diagnosis and treatment. Results: The median (quartile) of diagnostic interval was 10 (2, 48) days, and the diagnostic delay rate was 43.73% (3947/9025). The median (quartile) of treatment interval was 5 (0, 21) days, and the rate of treatment delay was 43.42% (3919/9025).The multivariate analysis revealed that patients having household registration in other counties (districts) within the same province (OR=1.252,95%CI:1.024-1.530), in other provinces (OR=1.363,95%CI:1.097-1.693), having previous history of anti-tuberculosis treatment (OR=1.743,95%CI:1.586-1.915) and belonging to non-key population (OR=1.518,95%CI:1.165-1.979) were risk factors for diagnostic delay. The risk factors for treatment delay included patients whose household registration was in the same province but not the same county/district (OR=1.404, 95%CI:1.148-1.717), in other provinces (OR=1.573,95%CI: 1.266-1.956), with a history of previous anti-tuberculosis treatment (OR=1.669,95%CI: 1.499-1.859), and those on short-course chemotherapy regimens (OR=1.491, 95%CI: 1.211-1.836). Conclusion: The rate of diagnosis and treatment delay in rifampicin-resistant TB patients was high in China. It is recommended to further strengthen the cross-regional management mechanism for tuberculosis patients and improve the accessibility of second-line anti-tuberculosis drugs, so as to shorten the diagnosis and treatment time and improve the quality of diagnosis and treatment of patients.

Key words: Tuberculosis, Rifampicin, Diagnosis, Delay, Risk factors