Risk Factors Associated With Tuberculosis Diagnostic Delay in the Jiangsu Province, China (2011-2021): Spatiotemporal...

Area of Science:

• Public Health
• Epidemiology
• Spatial Analysis

Background:

• Tuberculosis (TB) remains a significant global public health challenge.
• Delays in TB diagnosis hinder effective control strategies despite advancements in diagnostic tools.

Purpose of the Study:

• To investigate spatiotemporal patterns of TB diagnostic delay.
• To identify individual and spatial risk factors for TB diagnostic delay in Jiangsu Province, China (2011-2021).

Main Methods:

• Utilized data from 332,091 TB patients in Jiangsu Province (2011-2021).
• Defined diagnostic delay as >28 days from symptom onset to diagnosis.
• Employed logistic regression for individual factors and a Bayesian spatiotemporal Beta model for spatial analysis. Panel Granger causality explored temporal dynamics.

Main Results:

• Older adults, agricultural workers, migrants, and clinically diagnosed cases showed higher odds of delay.
• Male patients and educators had lower odds of delay.
• Significant spatial clustering of TB diagnostic delay rates was observed from 2015 onwards. Increased local patient proportion and resident population size correlated with decreased delay rates.

Conclusions:

• TB diagnostic delays are shaped by a combination of individual characteristics and spatial determinants.
• The proportion of local patients and population density are key factors in spatiotemporal variation of TB diagnostic delays.
• Targeted interventions for high-risk populations and healthcare settings are crucial for mitigating TB diagnostic delays.