Comparison of Delay in Tuberculosis Diagnosis Between Migrants and Local Residents in an Eastern County of China

An Analysis of the Electronic Data Between 2015 and 2019

Bibliographic Data

ID22084289
AuthorsWenhui Xiao (Guangzhou University of Chinese Medicine), Bin Chen (0000-0003-3287-934X, Zhejiang Center for Disease Control and Prevention), Dajiang Huang (0009-0009-3479-050X, Taiwan Centers for Disease Control), Olivia S K Chan (0000-0003-1684-8105), Olivia YM Chan (University of Hong Kong), Xiaolin Wei (0000-0002-3076-2650, University of Toronto), Lin Zhou (0000-0002-6428-7392, Zhejiang Center for Disease Control and Prevention, corresponding author), Guanyang Zou (0000-0001-6933-2749, Guangzhou University of Chinese Medicine, corresponding author)
Year2021
Volume9
Pages758335-758335
Publication date2021-11-18
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2021.758335
PMID34869174
OpenAlexW3213882280
LanguageEN
Citations received7
References cited29

Introduction: China continues to rank among one of the countries with the highest number of tuberculosis (TB) cases globally. Migrants are a particularly at-risk subgroup for TB and pose a challenge for case management in contemporary China. The early diagnosis and treatment of patients with TB are pivotal for effective TB control. This study investigates the delay in the TB diagnosis of migrants as compared with residents, to provide an evidence base for improved case detection and the better management of migrant patients with TB. Materials and Methods: The data was collected from the Tuberculosis Information Management System (TBIMS) (2015–2019) in an eastern county of China. The total diagnostic delay, consisting of patient delay and health system delay, is defined as the interval between the onset of TB symptoms and the confirmation of TB diagnosis in the designated TB hospital. The comparison of the delay in the TB diagnosis between migrants and residents was conducted using a Mann-Whitney U -test and chi-square test. The difference in the delay curves between these two groups was examined using a log-rank test. Results: Of 2,487 patients with TB, 539 (22%) were migrants. The migrants tended to be younger, presented with less severe conditions, received an initial diagnosis at prefectural and above-level hospitals. Compared with the local patients with TB, the migrant patients with TB had a longer median total diagnostic delay (30 vs. 9, P = 0.000) and a higher proportion of patients with this delay >28 days (52 vs. 13%, P = 0.000). Similarly, the migrant patients with TB also had a longer median patient delay (13 vs. 9, P = 0.000) and a higher proportion of patients with this delay >14 days (47 vs. 30%, P = 0.000), longer median health system delay (9 vs. 0, P = 0.000), and a higher proportion of patients with this delay >14 days (42 vs. 0.5%, P = 0.000) than the local patients with TB. The survival curves of delay showed that the longer the time interval was, the more likely the migrant patients with TB were to be diagnosed ( P < 0.05). Conclusions: Diagnosis is significantly delayed among migrant patients with TB. Our study highlights the importance of early screening and diagnosis for TB especially among migrants, to improve access and ensure better management for all patients with TB

Chi-square test · China · Mann–Whitney U test · Statistics · Tuberculosis · Demography · Healthcare Systems and Reforms · HIV/AIDS Impact and Responses · Medicine · Tuberculosis Research and Epidemiology · Internal Medicine · Pediatrics