Comparison of Delay in Tuberculosis Diagnosis Between Migrants and Local Residents in an Eastern County of China: An Analysis of the Electronic Data Between 2015 and 2019

Xiao, Wei; Chen, Bin; Huang, Dajiang; Chan, Olivia Ym; Wei, Xiaolin; Zhou, Lin; Zou, Guanyang

doi:10.3389/fpubh.2021.758335

Cited by 7 publications

(15 citation statements)

References 29 publications

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“…Migrant patients were thought to have more barriers to medical care, such as the inconvenience of medical insurance reimbursement and lack of time or social support ( 28 ). They were shown to have a longer delay in both patient care-seeking and hospital diagnosis in an eastern county of China ( 29 ). Active case-finding was less efficient among migrants than among residents, which also reminded us that the healthcare quality of migrants should be improved through multidimensional social support ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

Time-trend analysis of tuberculosis diagnosis in Shenzhen, China between 2011 and 2020

Chuangyue

Wang

Zhang

et al. 2023

Front. Public Health

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ObjectiveTo describe the trend of tuberculosis (TB) diagnosis in the migrant city Shenzhen, China, and analyze the risk factors of diagnosis delays.MethodsDemographic and clinical information of TB patients from 2011 to 2020 in Shenzhen were extracted. A bundle of measures to enhance TB diagnosis had been implemented since late 2017. We calculated the proportions of patients who underwent a patient delay (>30 days from syndrome onset to first care-seeking) or a hospital delay (>4 days from first care-seeking to TB diagnosis). Multivariable logistic regression was used to analyze the risk factors of diagnosis delays.ResultsDuring the study period, 43,846 patients with active pulmonary TB were diagnosed and registered in Shenzhen. On average, the bacteriological positivity rate of the patients was 54.9%, and this increased from 38.6% in 2017 to 74.2% in 2020. Overall, 30.3 and 31.1% of patients had a patient delay or a hospital delay, respectively. Molecular testing significantly increased bacteriological positivity and decreased the risk of hospital delay. People >35 years old, the unemployed, and residents had a higher risk of delays in both patient care-seeking and hospital diagnosis than younger people, workers, or migrants. Compared with passive case-finding, active case-finding significantly decreased the risk of patient delay by 5.47 (4.85–6.19) times.ConclusionThe bacteriological positivity rate of TB patients in Shenzhen increased significantly but the diagnosis delays were still serious, which may need more attention when active case-finding in risk populations and optimization of molecular testing.

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Section: Discussionmentioning

confidence: 99%

Time-trend analysis of tuberculosis diagnosis in Shenzhen, China between 2011 and 2020

Chuangyue

Wang

Zhang

et al. 2023

Front. Public Health

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“…Migrants, especially those from high burden areas, often have low economic access to medical services due to poor economic and medical security status [ 30 ]. Furthermore, young migrants turned to overestimate their health statues and delayed in seeking medical care [ 31 ]. Similarly, patients living in in rural areas or low-resource settings often have poor access to TB services because of their poor economic status or far distance from medical institutions [ 9 , 12 , 32 − 35 ].…”

Section: Discussionmentioning

confidence: 99%

Trends of a decade in risk factors of patient delay among pulmonary tuberculosis patients during fast aging and urbanization - analysis of surveillance data from 2008 to 2017 in Wuhan, China

Wang

et al. 2023

BMC Public Health

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Background Tuberculosis (TB) is a leading infectious cause of morbidity and mortality worldwide. However, delay in health care seeking has remained unacceptably high. The aim of this study was to clarify the trend of patient delay and its associated risk factors during rapid aging and urbanization in Wuhan, China from 2008 to 2017. Methods A total of 63,720 TB patients registered at Wuhan TB Information Management System from January 2008 to December 2017 were included. Long patient delay (LPD) was defined as patient delay longer than 14 days. Independent associations of area and household identity with LPD, as well their interaction effect, were tested by logistic regression models. Results Among 63,720 pulmonary TB patients, 71.3% were males, the mean age was 45.5 ± 18.8 years. The median patient delay was 10 days (IQR, 3–28). A total of 26,360 (41.3%) patients delayed for more than 14 days. The proportion of LPD decreased from 44.8% in 2008 to 38.3% in 2017. Similar trends were observed in all the subgroups by gender, age and household, except for living area. The proportion of LPD decreased from 46.3 to 32.8% in patients living near downtown and increased from 43.2 to 45.2% in patients living far from downtown. Further interaction effect analysis showed that among patients living far from downtown, the risk of LPD for local patients increased with age, while decreased with age for migrant patients. Conclusion Although the overall LPD among pulmonary TB patients declined in the past decade, the extent of reduction varied in different subgroups. The elderly local and young migrant patients living far from downtown are the most vulnerable groups to LPD in Wuhan, China.

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“…However, this study did not consider mortality from tuberculosis. In China, the median diagnosis of TB was significantly longer among immigrants than natives (30 vs. 9) with a high proportion of patients with a duration of >28 days (52% vs. 13%) [ 19 ]. In another Chinese study, the time from the first consultation to diagnosis was more than 30 days in 25% of kidney transplanted patients [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Identifying Risk Factors for Pulmonary Tuberculosis Diagnosis Delays in Mali a West-African Endemic Country

Soumaré¹,

Baya²,

Ouattara³

et al. 2022

JTR

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Background: Tuberculosis was the deadliest infectious agent before covid-19; 1.5 million deaths in 2020. Despite, a variety, of easy and cheap diagnostic tools, detection rates still fall below 90%; diagnosis delays are long exceeding 30 days in many continents. This study aimed to determine risk factors for pulmonary TB diagnosis delays in Mali. Methods: A cross-sectional study was conducted in Bamako to include pulmonary TB patients at treatment initiation centers. Verbal consent was obtained before the interview. Demographics, clinical, treatment cost, and patient, medical, and diagnostic delays were computed using SPSS 25.0 considering a significance level p < 0.05. Results: In total 266 patients were included, 80.8% were male, mean age was ± 12 years, primary education level was 50.4%, treatment cost before diagnosis was 100 - 200 thousand CFA in 65.4%, smokers were 42.1%, median patient, medical and total diagnostic delays were 58, 57 and 114 days respectively. Education level below university, social reasons, and non-request of health workers were identified as independent risk factors for diagnostic delay > 100 days in Mali Conclusion: Diagnostic delay is relatively very long in Mali, there is an urgent need for identification and action to shorten the delays to limit the transmission chain and avoid disabling pulmonary sequels.

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Comparison of Delay in Tuberculosis Diagnosis Between Migrants and Local Residents in an Eastern County of China: An Analysis of the Electronic Data Between 2015 and 2019

Cited by 7 publications

References 29 publications

Time-trend analysis of tuberculosis diagnosis in Shenzhen, China between 2011 and 2020

Time-trend analysis of tuberculosis diagnosis in Shenzhen, China between 2011 and 2020

Trends of a decade in risk factors of patient delay among pulmonary tuberculosis patients during fast aging and urbanization - analysis of surveillance data from 2008 to 2017 in Wuhan, China

Identifying Risk Factors for Pulmonary Tuberculosis Diagnosis Delays in Mali a West-African Endemic Country

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