Many TB patients in Huyanghe delayed seeking care, study finds

Researchers led by Fukui HE set out to describe how long people with pulmonary tuberculosis (TB) in Huyanghe City, Xinjiang, waited before seeking care and to identify factors linked to those delays. The study covers a ten-year period from 2014 to 2024 and aims to provide evidence to help develop targeted interventions to reduce care-seeking delays and strengthen TB prevention and control. Using records from TB-designated hospitals in Huyanghe City, the team analyzed data recorded in the Tuberculosis Patient Management Subsystem of the China CDC information system. The investigation was observational, focused on patient delay among people diagnosed with pulmonary TB, and used statistical approaches to look for relationships between patient characteristics and the likelihood of delaying care. By systematically describing the current status of patient delay over the decade, the study intended to show which groups were most likely to postpone seeking diagnosis and treatment and therefore where public health efforts might be concentrated.

The study extracted patient delay information for pulmonary TB patients registered and reported by TB-designated hospitals in Huyanghe City from 2014 to 2024. In total, 1,021 pulmonary TB patients were registered, and 534 of them had patient delay, a rate of 52.00%. Patient delay lasted a median of 24 days (IQR, 9~62). The researchers summarized continuous variables using the median and interquartile range and explored factors associated with patient delay using univariable analyses and multivariable logistic regression models. In multivariable models, male sex was associated with reduced odds of delay (OR:0.702, 95% CI:0.537~0.917), age >60 years was associated with reduced odds (OR:0.759, 95%CI:0.584~0.985), and presentation during the COVID-19 period was linked to reduced odds of delay (OR:0.658, 95%CI:0.465~0.932). Conversely, Han ethnicity (OR:1.936, 95% CI:1.168~3.207), pathogen positive (OR:1.923, 95% CI:1.079~3.426), comorbidities conditions (OR:1.652, 95% CI:0.987~2.764), and Employed (OR:2.293, 95% CI:1.694~3.103) increased the odds of delay.

The findings show that patient delay in pulmonary TB remained high in Huyanghe City over the 2014–2024 period, even though the overall trend was a decline. The results point to specific groups who were more likely to postpone care: younger people (under 60), women, those with comorbidities conditions, people who were employed, and patients who were pathogen positive. At the same time, being male, older than 60, or presenting during the COVID-19 period were associated with lower odds of delay. These patterns provide a clear evidence base for local public health planners: interventions aimed at reducing diagnostic and treatment delays should consider targeting the groups identified here. By focusing outreach, education, and access efforts on the populations most likely to delay, TB control programs in Huyanghe City can work to shorten delays, reduce transmission, and improve outcomes for people with pulmonary TB.