Epidemiological characteristics of pulmonary tuberculosis and factors influencing timely medical care seeking in the elderly in Jilin, 2016–2020

Objective To analyze the epidemiological characteristics of pulmonary tuberculosis (TB) in the elderly in Jilin province during the “13^th Five-Year Plan” period, identify the factors influencing timely medical care seeking of pulmonary TB cases in the elderly and provide evidence for the improvement of TB control strategies in the elderly.

Methods The incidence data of pulmonary TB in the elderly aged ≥60 years in Jilin from 2016 to 2020 were collected from Tuberculosis Management Information System, a subsystem of China Disease Prevention and Control Information System, for a descriptive epidemiological analysis. A multifactorial logistic regression model was established to analyze the factors influencing timely medical care seeking in elderly TB patients. Trend analysis was conducted by using the annual percentage change(APC).

Results The average reported incidence rate of pulmonary TB in the elderly was 76.49/100 000 in Jilin from 2016 to 2020; the average etiological positive rate of the pulmonary TB cases was 49.97% during this period, showing a gradual upward trend (APC=20.68%, t=5.791, P=0.01). The male to female ratio of the cases was 2.52∶1, the median onset age was 69.13 years, and 20 390 cases were reported in Han ethnic group. A total of 12 865 cases were farmers, and the cases reported in Changchun (4992 cases), Jilin (4351 cases), and Siping (3237 cases) ranked top three. The proportion of elderly pulmonary TB patients who sought treatment due to symptom or referral was highest (50.99%, 10890/21359), the rate of medical care seeking delay was 75.48% (16121/21359), there were 1215 cases of severe pulmonary TB, and the successful treatment rate of the elderly pulmonary TB patients was 76.56% (16352/21359). The multivariate logistic regression analysis results showed that compared with non-farmers, non-floating population, the patients without etiological results and farmers odds ratio(OR)=1.273, 95% confidence interval(CI): 1.193–1.357, being in floating population (OR=1.134, 95%CI: 1.012–1.272), and being etiological positive (OR=1.260, 95%CI: 1.180–1.346) were the risk factors for medical care seeking delay; being aged 70–80 years (OR=0.873, 95%CI: 0.796–0.957), being in initial treatment (OR=0.752, 95%CI: 0.668–0.846), and severe illness (OR=0.799, 95%CI: 0.699–0.914) were protective factors against medical care seeking delay.

Conclusion During the “13^th Five-Year Plan” period, the reported incidence rate of pulmonary tuberculosis in the elderly in Jilin showed an increase firstly, then decreased, and the medical care seeking rate of the elderly pulmonary TB patients was high. It is necessary to take comprehensive prevention and control measures to improve the detection of pulmonary TB in the elderly.