Factors associated with tuberculosis patient delay: a meta-analysis

Area of Science:

• Public Health
• Epidemiology
• Global Health

Background:

• Tuberculosis (TB) remains a leading global cause of death, with patient delay identified as a critical factor contributing to higher mortality rates.
• Understanding the multifaceted factors associated with patient delay is crucial for developing effective public health interventions to combat TB.

Purpose of the Study:

• To systematically analyze and identify key factors associated with patient delay in seeking diagnosis and treatment for tuberculosis.

Main Methods:

• A comprehensive systematic literature search was conducted across major databases (Embase, Cochrane Library, PubMed, Web of Science) up to 2025.
• Meta-analysis techniques were employed using STATA 15.1 to synthesize data from 42 included studies involving 492,448 patients.
• Study quality was rigorously assessed using the Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality criteria.

Main Results:

• Patient delay was significantly associated with occupation, educational level, place of residence, TB classification, alcohol consumption, TB knowledge, and perceived stigma.
• Conversely, diabetes and HIV infection showed an association with reduced patient delay.
• Factors such as age, sex, marital status, BMI, insurance, smoking, and distance to health services did not demonstrate a significant association with patient delay.

Conclusions:

• Patient delay in TB diagnosis negatively impacts treatment outcomes, prognosis, and increases the societal and familial burden.
• Interventions focused on enhancing health education, improving healthcare service systems, and implementing early screening programs are recommended to mitigate patient delay.