Factors associated with health care-seeking delay and treatment delay in tuberculosis patients in Shishou and Badong of Hubei

Abstract

Objective To investigate the current status of health care-seeking delay and treatment delay of tuberculosis (TB) patients and the influencing factors in two counties of Hubei Province, and provide evidence for the early detection and early treatment of TB patients. Methods Cross-sectional survey was conducted through face to face interview and collection of patient's medical record information, outpatient and inpatient records of hospitals for univariate analysis and logistic regression analysis to identify the factors independently associated with the health care-seeking delay and treatment delay. Results The median of health care seeking delay was 7 days (IQR: 0–30), the risk factors associated with health care-seeking delay were cough or expectoration (OR=1.97, 95% CI: 1.04–3.75), distance to a health facility for the first health care seeking >20 km (OR=2.35, 95% CI: 1.36–4.06), but chest pain (OR=0.47, 95% CI: 0.25–0.89) was the protective factor for health care seeking delay. The median of treatment delay was 24 days (IQR: 13–54), the number of health care seeking and number of different medical institutions visited were independent factors for treatment delay (P 30 km (OR=1.92, 95% CI: 1.04–3.55), the number of health care seeking (3–4 times: OR=2.50, 95% CI: 1.25–4.97, >4 times: OR=25.42, 95% CI: 5.19–124.44). Conclusion In this study, the total delay of TB patients was mainly caused by treatment delay. While taking measures to reduce health care seeking delay, it is still necessary to improve patient's health care seeking behavior, optimize patient access to medical institutions, improve the watchfulness and diagnosis level of TB of non-designated TB medical institutions and use molecular biology and other means for screening to reduce treatment delay of TB patients.