Factors associated with delayed tuberculosis diagnosis in China

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Services Research

Background:

• Delayed tuberculosis diagnosis contributes to community transmission.
• Lack of access to care is a primary driver of diagnostic delays.
• This study investigated tuberculosis testing delays and risk factors in China.

Purpose of the Study:

• To evaluate the duration of delay in tuberculosis testing.
• To identify risk factors associated with delayed tuberculosis diagnosis.
• To compare diagnostic delays across different regions in China.

Main Methods:

• Prospective cohort study of 765 culture-positive pulmonary tuberculosis patients.
• Data collected via questionnaire on symptom onset to diagnosis testing delay.
• Analysis of patient information and demographic factors.

Main Results:

• Median delay in tuberculosis diagnosis was 36 days.
• Shanghai patients experienced shorter delays (30 days) compared to Shandong/Sichuan (42 days).
• Risk factors for delays included cough, low income, marital status, and female gender in specific regions. Other symptoms like hemoptysis shortened delays.

Conclusions:

• Interventions must focus on vulnerable populations to shorten tuberculosis diagnostic delays.
• Cough, a non-specific symptom, is associated with prolonged delays and increased transmission risk.
• Enhanced healthcare worker training in high-incidence areas is critical, especially for managing cough patients.