Trends of a decade in risk factors of patient delay among pulmonary tuberculosis patients during fast aging and urbanization - analysis of surveillance data from 2008 to 2017 in Wuhan, China
Abstract Background Tuberculosis (TB) is a leading infectious cause of morbidity and mortality worldwide. However, delay in health care seeking has remained unacceptably high. The aim of this study was to clarify the trend of patient delay and its associated risk factors during rapid aging and urban...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2023-05-01
|
Series: | BMC Public Health |
Subjects: | |
Online Access: | https://doi.org/10.1186/s12889-023-15707-7 |
_version_ | 1797831920688562176 |
---|---|
author | Xiaojun Wang Yuehua Li Qian Fu Meilan Zhou |
author_facet | Xiaojun Wang Yuehua Li Qian Fu Meilan Zhou |
author_sort | Xiaojun Wang |
collection | DOAJ |
description | Abstract Background Tuberculosis (TB) is a leading infectious cause of morbidity and mortality worldwide. However, delay in health care seeking has remained unacceptably high. The aim of this study was to clarify the trend of patient delay and its associated risk factors during rapid aging and urbanization in Wuhan, China from 2008 to 2017. Methods A total of 63,720 TB patients registered at Wuhan TB Information Management System from January 2008 to December 2017 were included. Long patient delay (LPD) was defined as patient delay longer than 14 days. Independent associations of area and household identity with LPD, as well their interaction effect, were tested by logistic regression models. Results Among 63,720 pulmonary TB patients, 71.3% were males, the mean age was 45.5 ± 18.8 years. The median patient delay was 10 days (IQR, 3–28). A total of 26,360 (41.3%) patients delayed for more than 14 days. The proportion of LPD decreased from 44.8% in 2008 to 38.3% in 2017. Similar trends were observed in all the subgroups by gender, age and household, except for living area. The proportion of LPD decreased from 46.3 to 32.8% in patients living near downtown and increased from 43.2 to 45.2% in patients living far from downtown. Further interaction effect analysis showed that among patients living far from downtown, the risk of LPD for local patients increased with age, while decreased with age for migrant patients. Conclusion Although the overall LPD among pulmonary TB patients declined in the past decade, the extent of reduction varied in different subgroups. The elderly local and young migrant patients living far from downtown are the most vulnerable groups to LPD in Wuhan, China. |
first_indexed | 2024-04-09T13:59:28Z |
format | Article |
id | doaj.art-f3bff612ef9f477e9e57434998e88985 |
institution | Directory Open Access Journal |
issn | 1471-2458 |
language | English |
last_indexed | 2024-04-09T13:59:28Z |
publishDate | 2023-05-01 |
publisher | BMC |
record_format | Article |
series | BMC Public Health |
spelling | doaj.art-f3bff612ef9f477e9e57434998e889852023-05-07T11:26:06ZengBMCBMC Public Health1471-24582023-05-012311810.1186/s12889-023-15707-7Trends of a decade in risk factors of patient delay among pulmonary tuberculosis patients during fast aging and urbanization - analysis of surveillance data from 2008 to 2017 in Wuhan, ChinaXiaojun Wang0Yuehua Li1Qian Fu2Meilan Zhou3Wuhan Institute for Tuberculosis Control, Wuhan Pulmonary HospitalWuhan Institute for Tuberculosis Control, Wuhan Pulmonary HospitalSchool of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and TechnologyWuhan Institute for Tuberculosis Control, Wuhan Pulmonary HospitalAbstract Background Tuberculosis (TB) is a leading infectious cause of morbidity and mortality worldwide. However, delay in health care seeking has remained unacceptably high. The aim of this study was to clarify the trend of patient delay and its associated risk factors during rapid aging and urbanization in Wuhan, China from 2008 to 2017. Methods A total of 63,720 TB patients registered at Wuhan TB Information Management System from January 2008 to December 2017 were included. Long patient delay (LPD) was defined as patient delay longer than 14 days. Independent associations of area and household identity with LPD, as well their interaction effect, were tested by logistic regression models. Results Among 63,720 pulmonary TB patients, 71.3% were males, the mean age was 45.5 ± 18.8 years. The median patient delay was 10 days (IQR, 3–28). A total of 26,360 (41.3%) patients delayed for more than 14 days. The proportion of LPD decreased from 44.8% in 2008 to 38.3% in 2017. Similar trends were observed in all the subgroups by gender, age and household, except for living area. The proportion of LPD decreased from 46.3 to 32.8% in patients living near downtown and increased from 43.2 to 45.2% in patients living far from downtown. Further interaction effect analysis showed that among patients living far from downtown, the risk of LPD for local patients increased with age, while decreased with age for migrant patients. Conclusion Although the overall LPD among pulmonary TB patients declined in the past decade, the extent of reduction varied in different subgroups. The elderly local and young migrant patients living far from downtown are the most vulnerable groups to LPD in Wuhan, China.https://doi.org/10.1186/s12889-023-15707-7Patient delayTuberculosisRisk factorsAgingUrbanization |
spellingShingle | Xiaojun Wang Yuehua Li Qian Fu Meilan Zhou Trends of a decade in risk factors of patient delay among pulmonary tuberculosis patients during fast aging and urbanization - analysis of surveillance data from 2008 to 2017 in Wuhan, China BMC Public Health Patient delay Tuberculosis Risk factors Aging Urbanization |
title | Trends of a decade in risk factors of patient delay among pulmonary tuberculosis patients during fast aging and urbanization - analysis of surveillance data from 2008 to 2017 in Wuhan, China |
title_full | Trends of a decade in risk factors of patient delay among pulmonary tuberculosis patients during fast aging and urbanization - analysis of surveillance data from 2008 to 2017 in Wuhan, China |
title_fullStr | Trends of a decade in risk factors of patient delay among pulmonary tuberculosis patients during fast aging and urbanization - analysis of surveillance data from 2008 to 2017 in Wuhan, China |
title_full_unstemmed | Trends of a decade in risk factors of patient delay among pulmonary tuberculosis patients during fast aging and urbanization - analysis of surveillance data from 2008 to 2017 in Wuhan, China |
title_short | Trends of a decade in risk factors of patient delay among pulmonary tuberculosis patients during fast aging and urbanization - analysis of surveillance data from 2008 to 2017 in Wuhan, China |
title_sort | trends of a decade in risk factors of patient delay among pulmonary tuberculosis patients during fast aging and urbanization analysis of surveillance data from 2008 to 2017 in wuhan china |
topic | Patient delay Tuberculosis Risk factors Aging Urbanization |
url | https://doi.org/10.1186/s12889-023-15707-7 |
work_keys_str_mv | AT xiaojunwang trendsofadecadeinriskfactorsofpatientdelayamongpulmonarytuberculosispatientsduringfastagingandurbanizationanalysisofsurveillancedatafrom2008to2017inwuhanchina AT yuehuali trendsofadecadeinriskfactorsofpatientdelayamongpulmonarytuberculosispatientsduringfastagingandurbanizationanalysisofsurveillancedatafrom2008to2017inwuhanchina AT qianfu trendsofadecadeinriskfactorsofpatientdelayamongpulmonarytuberculosispatientsduringfastagingandurbanizationanalysisofsurveillancedatafrom2008to2017inwuhanchina AT meilanzhou trendsofadecadeinriskfactorsofpatientdelayamongpulmonarytuberculosispatientsduringfastagingandurbanizationanalysisofsurveillancedatafrom2008to2017inwuhanchina |