Objective To analyze the diagnosis timeliness and detection rate of pulmonary tuberculosis(TB) and its influencing factors of pulmonary TB patients newly diagnosed by non-designated medical institutions in Henan province and explore measures to avoid the delay in diagnosis and improve the detection rate.

Methods Retrospective cohort study was used. The data of suspected and clinically diagnosed pulmonary TB cases diagnosed by non-designated medical institutions in Henan from 2019 to 2023 were collected from the Chinese Disease Prevention and Control Information System. The days required for the diagnosis of pulmonary TB by the designated medical institutions were calculated. The factors affecting the diagnosis timeliness of pulmonary TB were analyzed. Kaplan-Meier method was used for univariate analysis, log-rank method was used for inter group comparison, and Cox regression model was used for multivariate analysis.

Results In 180737 suspected and clinically diagnosed pulmonary TB cases included in the study, 53818 were diagnosed with pulmonary TB by the designated medical institutions, with a detection rate of 29.78%. The diagnosis time M(P₂₅, P₇₅) was 35 (5,96) days. The cases with the longest diagnosis time were characterized by being suspected cases (78 days), being examined by city and county medical institutions (74 days), being traced (69 days), making the first visit to primary medical institution (64 days), and being aged 65−94 years (52 days). Cox multivariate analysis revealed that being suspected cases (HR=0.25, 95%CI: 0.25−0.26), being examined by city and county level medical institution(HR=0.50, 95%CI: 0.48−0.52), being traced (HR=0.62, 95.0%CI: 0.61−0.64), making the first visit to primary medical institution (HR=0.61, 95%CI: 0.58～0.63), being aged 65−94 years (HR=0.68, 95%CI: 0.66−0.70); being diagnosed during an emerging infectious disease pandemic period (HR=0.87, 95%CI: 0.86-0.89), referral to local county and district medical institutions (HR=0.91, 95%CI: 0.88−0.93); being farmer (HR=0.91, 95%CI: 0.89−0.93); being woman (HR=0.92, 95%CI: 0.91−0.94) and being not hospitalized (HR=0.93, 95%CI: 0.89−0.97) were independent influencing factors of diagnosis timeliness.

Conclusion The influencing factors of delayed diagnosis of pulmonary TB in non-designated medical institutions in Henan included the factors from both patients and medical institutions. It is necessary to improve the rapid diagnosis of pulmonary TB in both designated medical institutions and non-designated medical institutions, strengthen cooperation of medical treatment and prevention service as well as health education in key populations, such as the elderly and farmers, to improve the detection rate of pulmonary TB, shorten the diagnosis interval for the goal of ending TB.