Objective  To analyze the current status of health-care seeking delay in students with pulmonary tuberculosis (TB) and influencing factors in Qinghai province from 2011 to 2020, and provide a scientific basis for effective prevention and control of pulmonary TB in students in the future.

  Methods  The date of pulmonary TB in students in Qinghai from 2011 to 2020 were obtained from National Tuberculosis Management Information System. Statistical software SPSS 19.0 was used to conduct χ² test, trend χ² test, multivariate logistic regression analysis.

  Results  From 2011 to 2020, a total of 4 496 pulmonary TB cases were diagnosed in students in Qinghai, in which 2 168 cases had health-care seeking delay, the health-care seeking delay rate was 48.22%, showing a downward trend（trend χ²=360.186, P<0.01）, the median of health-care seeking days was 14 (P₂₅,P₇₅: 2, 36). The results of multivariate logistic regression analysis showed that Tibetan students (OR=0.636, 95% CI: 0.511–0.791) and those receiving other health check-up (OR=0.667, 95% CI: 0.483–0.914) had lower risk for health-care seeking delay. The students who had symptom based referral (OR=3.565, 95% CI: 2.275–5.774), the students who had referral (OR=2.363, 95% CI: 1.849–3.037) and the students receiving follow-up (OR=1.288, 95% CI: 1.110–1.494), the students diagnosed with Ⅱ TB (OR=2.051, 95% CI: 1.516–2.786), Ⅲ TB (OR=2.465, 95% CI: 1.940–3.155), Ⅳ TB (OR=2.678, 95% CI: 2.001–3.602) and the students who had retreatment had higher risk for health-care seeking delay, the differences were significant (P<0.05).

  Conclusion  From 2011 to 2020, the health-care seeking delay rate of pulmonary TB cases in students in Qinghai was relatively high, but showed a downward trend. Ethnic group, source of patients, diagnosis type and treatment classification were the influencing factors for health-care seeking delay. More attention should be paid to the pulmonary TB cases in students at high risk for health-care seeking delay.