Health-care seeking delay among local and nonlocal pulmonary tuberculosis patients and its influencing factors in Guizhou, 2015−2020

  Objective  To describe the characteristics of the health-care seeking delay in local and nonlocal pulmonary tuberculosis (TB) patients in Guizhou province from 2015 to 2020, analyze the influencing factors and provide evidence for the prevention and control of pulmonary TB in Guizhou.

  Methods  The medical record information of patients diagnosed with pulmonary TB in Guizhou between 2015 and 2020 were collected from “Tuberculosis Information Management System”, and the factors influencing the health-care seeking delay were analyzed by using χ² test and Logistic regression model.

  Results  From 2015 to 2020, the overall health-care seeking delay rate of pulmonary TB patients was 65.14% in Guizhou, and the health-care seeking delay rates in local and nonlocal pulmonary TB patients were 64.72% and 65.55%, respectively, all showing a downward trend (trend χ²_overall=334.604, χ²_local=224.600, χ²_nonlocal=139.364, P<0.001). The health-care seeking delay rates were highest in both local (75.20%) and nonlocal (70.80%) patients in Tongren. The results of multivariate analysis showed that being woman (OR_local=1.024, OR_nonlocal=1.012), being aged 30–44 years (OR_local=1.056, OR_nonlocal=1.077), being aged 45–59 years (OR_local=1.211, OR_nonlocal=1.287), being aged ≥60 years (OR_local=1.289, OR_nonlocal=1.334), non-farmers (being student (OR_local=0.744, OR_nonlocal=0.694), being worker (OR_local=0.744, OR_nonlocal=0.505), being unemployed (OR_local=0.809), OR_nonlocal=0.788), passive detection (OR_local=3.772, OR_nonlocal=3.319), referral (OR_local=3.233, OR_nonlocal=2.266), seeking medical care due to symptoms (OR_local=4.626, OR_nonlocal=3.042), symptom based referral (OR_local=2.995, OR_migrated=3.195), and being severe patients (OR_local=1.134, OR_migrated=1.120) were the common risk factors for the health-care seeking delay in both local and nonlocal pulmonary TB patient in Guizhou.

  Conclusion  From 2015 to 2020, the delay rates in local and nonlocal pulmonary TB patients in Guizhou were relatively high. Comprehensive measures should be taken to further improve the health-care seeking in key areas and key populations.