BACKGROUND: Early diagnosis and treatment are essential for effective tuberculosis (TB) control. However, delays in the diagnosis and treatment of TB in central China have not been sufficiently investigated. This cross-sectional study was conducted between October 2013 and March 2014 in Hubei, China to identify risk factors of delays in care seeking, diagnosis and treatment among patients with TB. METHODS: A total of 1342 patients with TB seen in the designated institutions were included. Multivariate logistic regression was used to analyse factors associated with delays in TB diagnosis and treatment. RESULTS: Overall, 21.54%, 23.62% and 42.25% of patients with TB experienced delays in care seeking, diagnosis and treatment, respectively. Multivariate logistic regression showed that medical insurance and monthly household income were significantly associated with delays in care seeking. The time to reach a township hospital or the facility of a patient's first consultation was significantly associated with delays in diagnosis. Sex, education, time to reach a township hospital and the facility where the diagnosis was made were significantly associated with delays in treatment. CONCLUSIONS: Delays in TB diagnosis and treatment in Hubei remain a serious issue. Improvements in the capability and accessibility of health care services are imperative to reduce delays and expedite TB diagnosis and treatment.
BACKGROUND: Early diagnosis and treatment are essential for effective tuberculosis (TB) control. However, delays in the diagnosis and treatment of TB in central China have not been sufficiently investigated. This cross-sectional study was conducted between October 2013 and March 2014 in Hubei, China to identify risk factors of delays in care seeking, diagnosis and treatment among patients with TB. METHODS: A total of 1342 patients with TB seen in the designated institutions were included. Multivariate logistic regression was used to analyse factors associated with delays in TB diagnosis and treatment. RESULTS: Overall, 21.54%, 23.62% and 42.25% of patients with TB experienced delays in care seeking, diagnosis and treatment, respectively. Multivariate logistic regression showed that medical insurance and monthly household income were significantly associated with delays in care seeking. The time to reach a township hospital or the facility of a patient's first consultation was significantly associated with delays in diagnosis. Sex, education, time to reach a township hospital and the facility where the diagnosis was made were significantly associated with delays in treatment. CONCLUSIONS: Delays in TB diagnosis and treatment in Hubei remain a serious issue. Improvements in the capability and accessibility of health care services are imperative to reduce delays and expedite TB diagnosis and treatment.
Authors: Huan Wang; Markus Zhang; Robin Li; Oliver Zhong; Hannah Johnstone; Huan Zhou; Hao Xue; Sean Sylvia; Matthew Boswell; Prashant Loyalka; Scott Rozelle Journal: Int J Equity Health Date: 2021-01-14