Duration and Determinants of Delayed Diagnosis with Tuberculosis in Shenzhen, China: A Cross-Sectional Study

Jiang, Youli1; Luo, Lan2,3; Gui, Min1; Liu, Linlin1; Lin, Yi2,3; Deng, Guofang2,3; Chen, Jingfang1,3; Zhang, Peize2,3

2022

10.2147/RMHP.S367998

RISK MANAGEMENT AND HEALTHCARE POLICY   Impact Factor & Quartile

1179-1594

Background: Early diagnosis and timely treatment of tuberculosis are critical for disease control and management. However, diagnostic delay remains severe around the world. We aim to evaluate the duration and factors associated with diagnostic delay of Methods: We conducted a face-to-face interview to collect the whole care-seeking process of patients diagnosed with active TB in Shenzhen, China, from April 1 to September 30, 2021. The duration from symptom onset to confirmed diagnosis was recorded. The risk factors of diagnostic delay were identified by binary stepwise logistic regression analysis. Results: Among 288 confirmed TB cases, 170 (59.0%) were delayed diagnosis. The median diagnostic delay was 39.5 days. Median patient delay was 23 days and health system delay was 7 days. Income <= 315USD/month (OR = 2.97 [95% CI: 1.15-7.69]), cough (OR = 3.00 [95% CI: 1.16-7.76]), weight loss (OR = 15.59 [95% CI: 1.85-131.56]), use of traditional Chinese Medicine (OR = 5.03 [95% CI: 1.04-24.31]) and over-the-counter cough syrup (OR = 2.73 [95% CI: 1.10-6.76]) were significant risk factors for patient delay. Fever (OR = 0.13[95% CI: 0.04- 0.48]) and hemoptysis (OR = 0.06 [95% CI0.01-0.30]) were protective factors for patient delay. Cough (OR = 2.85 [95% CI: 1.49-5.49]) and availability of chest X-ray (OR = 0.21[CI: 0.11-0.39]) were factors associated with health system delay. Conclusion: Delayed diagnosis of tuberculosis remains an unresolved problem. Patients with low income, self-treatment with overthe-counter medicine and accepting TCM suffered from a higher risk of patient delay. It is important to give more help to the vulnerable people and strengthen tuberculosis knowledge among primary health providers. Keeping all health providers alert to TB symptoms can facilitate earlier TB diagnosis and better disease control.

tuberculosis diagnosis delay patient delay health system delay

SCI ; SSCI

English

Corresponding

Guangdong Provincial Clinical Research Center for Infectious Diseases[2020B1111170014] ; Summit Plan for Foshan High-level Hospital Construction[FSSYKF-2020001]

Health Care Sciences & Services

Health Care Sciences & Services ; Health Policy & Services

WOS:000834668700001

DOVE MEDICAL PRESS LTD

Web of Science

1.Univ South China, Hengyang Med Sch, Sch Nursing, Hengyang, Peoples R China
2.Third Peoples Hosp Shenzhen, Dept Pulm Med & TB, Shenzhen, Peoples R China
3.Southern Univ Sci & Technol, Peoples Hosp Shenzhen 3, Natl Clin Res Ctr Infect Dis, Affiliated Hosp 2, Shenzhen, Peoples R China

Jiang, Youli,Luo, Lan,Gui, Min,et al. Duration and Determinants of Delayed Diagnosis with Tuberculosis in Shenzhen, China: A Cross-Sectional Study[J]. RISK MANAGEMENT AND HEALTHCARE POLICY,2022,15.

Jiang, Youli.,Luo, Lan.,Gui, Min.,Liu, Linlin.,Lin, Yi.,...&Zhang, Peize.(2022).Duration and Determinants of Delayed Diagnosis with Tuberculosis in Shenzhen, China: A Cross-Sectional Study.RISK MANAGEMENT AND HEALTHCARE POLICY,15.

Jiang, Youli,et al."Duration and Determinants of Delayed Diagnosis with Tuberculosis in Shenzhen, China: A Cross-Sectional Study".RISK MANAGEMENT AND HEALTHCARE POLICY 15(2022).