Factors associated with diagnostic delay for primary pulmonary tuberculosis patients in Zhejiang province

Objective To explore the impact factors of diagnostic delay for primary pulmonary tuberculosis(TB) patients,and to provide basis for early control of tuberculosis.Methods With retrospective design,the information for 31 287 primary(TB) cases were collected from medical records from January 1 to December 31,2009 to analyze the impact factors of diagnostic delay.Results The median of patient delay,doctor diagnostic delay,total patient delay time was 17 days,1 day,and 21 days and the rate of patient delay,doctor diagnostic delay,total patient delay was 55.7%,7.1%,and 62.9%,respectively.Logistic regression analyses showed that risk factors for diagnostic delay included female,children and elderly,with low-income occupation,having treatment of other diseases,living in island or mountainous area,being diagnosis and treatment in public heath institution,smear-positive cases,severe cases,and detention individuals.The protective factors for diagnostic delay included male,young and adults,with high-income occupation,floating population,taking physical examination and referral track in plain or basin areas,having diagnosis and treatment in the fixed hospital,smear-negative cases,and minor cases.Conclusion The patient delay time is significantly longer than doctor diagnostic delay time.The impact factors of diagnostic delay for primary pulmonary tuberculosis patients included gender,age,occupation,household,being detention individual,patient source,living area,type of treatment and diagnosis institution and the state of TB.