Factors associated with patient delay among new tuberculosis patients in Anqing, China

Tuberculosis remains a serious global public health problem. Delays in diagnosis and treatment of tuberculosis patients not only increases transmission of tuberculosis in the community but may also lead to more serious complications and higher mortality. The objective of this study was to assess factors associated with patient delay among new pulmonary tuberculosis patients in Anqing, China. From June 2013 to December 2014, a cross-sectional study was carried out among 1083 new pulmonary tuberculosis patients. Data were collected using a structured questionnaire (interviewer-administered questionnaire for illiterate patients and self-administered questionnaire for literate patients) and tuberculosis management system. All participants were divided into longer patient delay and shorter patient delay groups and non-conditional logistic regression was applied to determine the factors associated with longer patient delay. The median patient delay was 11 days (interquartile range: 1-34). The logistic regression showed that factors associated with longer patient delay included having expectoration when first consulted the healthcare system (OR: 1.520; 95 % CI: 1.020-2.266; P=0.040), having blood-tinged sputum when first consulted the healthcare system (OR: 0.490; 95% CI: 0.278-0.864; P=0.014) and unknown whether there were tuberculosis patients around (OR: 1.903; 95 % CI: 1.229-2.947; P=0.004). Tuberculosis patients with different symptoms seem to have different behaviors of patient delay. A combination of interventions is needed to encourage tuberculosis patients to seek appropriate healthcare as early as possible.