Objective  To understand the current status of medical care seeking delay and key influencing factors in pulmonary tuberculosis (TB) patients in Gansu province, and provide scientific support for the early detection and prevention of pulmonary TB in Gansu.

Methods  Descriptive statistical method was used to analyze registered data of pulmonary TB patients in Gansu during 2018 - 2023 collected from China Disease Prevention and Control Information Management System. Spatial distribution visualization was conducted to analyze the medical care seeking delay in the pulmonary TB patients. Based on variables such as gender, age, ethnicity, occupation, patient origin, and treatment type, regression models were used to analyze key factors influencing the medical care seeking delay. Statistical significance was set at P<0.05.

Results  From 2018 to 2023,a total of 38 088 pulmonary TB patients were registered in Gansu. The median interval between onset and medical care seeking was 27 (7-60) days, and 24 520 patients had medical care seeking delay (64.37%).Regions with high seeking delay rates were in central, eastern and southern Gansu. Significant differences were observed in the proportions of delayed and non-delayed treatment among the patients in different gender, ethnic, occupation, residence and age groups, or with different pathogen test results, with complications or not, and detected by different methods (all P<0.001).Compared with other ethnic groups, the patients in Han ethnic group had higher risk for medical care seeking delay odd ratio (OR)=1.18, 95% confidential interval(CI):1.10-1.27. Compared with students, farmers and herders had higher risk for medical care seeking delay (OR=1.16, 95%CI:1.01-1.34). Compared with non-floating population, floating population had higher risk for medical care seeking delay (OR=1.11,95%CI:1.02-1.19). Compared with pathogen-positive patients, pathogen-negative patients had higher risk for medical care seeking delay (OR=1.06, 95%CI: 1.01-1.10). Compared with the patients with complications, those without complications had higher risk for medical care seeking delay (OR=1.21, 95%CI:1.11-1.32). Compared with the actively detected cases, the passively detected cases had higher risk for medical care seeking delay (OR=6.04, 95%CI: 5.69-6.41).

Conclusion From 2018 to 2023, the prevalence of medical care seeking delay in pulmonary TB patients was high in Gansu. Key factors contributing to medical care seeking delay included Han Chinese ethnicity, being farmer or herder, being floating, being pathogen-negative, having no complication, being passively detected case. In the future, it is necessary to strengthen the health education in farmers, herders, and floating population, and improve active case detection to optimize the prevention and control strategies for pulmonary TB.