Analysis on seeking medical treatment delay and influencing factors of tuberculosis patients among students in Wuhan,China during 2012－2023

Abstract

Background Tuberculosis (TB) treatment delay is one of the major challenges to end tuberculosis in many developing countries. Such cases may contribute to an increased TB transmission and severity of illness.Timely detection and treatment of tuberculosis is an effective means to control tuberculosis especially in school where is a place with dense crowds and strong mobility.This study aims to assess the magnitude of student patient delay in seeking medical treatment and associated factors in Wuhan,China. Methods We used the medical record information of PTB patients of students in Wuhan recorded by the National Tuberculosis Management Information System(TBIMS) in 2012-2023,then exported to the Statistical Package for Social Science (SPSS) version 25 to analyze the delay and change trend of seeking medical treatment of student tuberculosis patients, and took Multi-variable logistic regression method to ascertain the factors affecting the delay of seeking medical treatment of students. Results The median time of student TB patients in seeking medical treatment was 11 (5,21) days in Wuhan, and 38.54% of involved student TB patients in seeking medical treatment for more than 14 days after onset of their TB symptoms. From 2012 to 2023, except for the year of COVID-19, there was little fluctuation in the delay of students seeking medical treatment for tuberculosis in other years. during COVID།19, the time from symptoms onset to seeking medical treatment was significantly shorter due to the strengthening of school morning and afternoon examinations and symptom screening,the proportion of students aged ≥ 18 seeking medical treatment for tuberculosis is the highest among age groups.The results of multivariate analysis showed that near urban area, female, 13–18years old, ethnic minorities, and follow-up patients were at higher risk of delay in seeking medical treatment, and different ethnic groups and patient sources were the main influencing factors of delay in treatment. Conclusion There was a high prevalence of delay in seeking medical treatment among pulmonary tuberculosis (PTB) student patients in Wuhan, nearly 1/4 of student patients experienced the delay of seeking medical treatment. Students from ethnic minorities or abroad, as well as patients from the tracking group were factors associated with delay in seeking medical treatment. Providing health education to the community and more active case tracking by staff in grassroots community health service centers would minimize the delay.