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| Delay in healthcare-seeking and definitive diagnosis among elderly patients with pulmonary tuberculosis in Jiashan County from 2014 to 2023 |
| ZHU Ying, LING Yuxiao, ZHU Huihong
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| Jiashan County Center for Disease Control and Prevention (Jiashan County Institute of Public Health Supervision), Jiashan, Zhejiang 314100, China |
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Abstract Objective To analyze the status and influencing factors of healthcare-seeking delay and definitive diagnosis delay among elderly patients with pulmonary tuberculosis in Jiashan County, Zhejiang Province from 2014 to 2023, so as to provide evidence for improving tuberculosis prevention and control strategies. Methods Data on pulmonary tuberculosis patients aged ≥60 years registered in Jiashan County from 2014 to 2023 were collected through the Tuberculosis Information Management System of the Chinese Disease Prevention and Control Information System. The data included demographic information such as age and current address, as well as diagnostic and treatment information, including first-diagnosed hospital and etiological results. The rates of healthcare-seeking delay and definitive diagnosis delay were analyzed. Factors affecting delay in healthcare-seeking and definitive diagnosis among elderly patients with pulmonary tuberculosis were analyzed using a multivariable logistic regression model. Results A total of 508 elderly patients with pulmonary tuberculosis registered in Jiashan County from 2014 to 2023 were included. The median age was 71.00 (interquartile range, 12.00) years. There were 403 males (79.33%) and 105 females (20.67%). There were 273 patients with healthcare-seeking delay, with a healthcare-seeking delay rate of 53.74%, showing an increasing trend from 2014 to 2023 (P<0.05). There were 73 patients with definitive diagnosis delay, with a definitive diagnosis delay rate of 14.37%, and no statistically significant trend was observed during the same period (P>0.05). Multivariable logistic regression analysis showed that elderly patients with pulmonary tuberculosis whose first-visit institution was located in Jiashan County (OR=4.453, 95%CI: 3.007-6.593) and those with negative etiological results (OR=1.738, 95%CI: 1.112-2.717) had a higher risk of healthcare-seeking delay. Patients with first-diagnosed hospital located in Jiashan County (OR=7.728, 95%CI: 3.550-16.820) and those with current address in Yaozhuang Town (OR=5.318, 95%CI: 2.012-14.056) or Taozhuang Town (OR=3.848, 95%CI: 1.299-11.404) had a higher risk of definitive diagnosis delay. Conclusions From 2014 to 2023, the healthcare-seeking delay rate among elderly patients with pulmonary tuberculosis in Jiashan County was relatively high and showed an increasing trend, while the definitive diagnosis delay rate was relatively low. First-diagnosed hospital location, etiological results, and current address were the main influencing factors.
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Received: 09 January 2026
Revised: 13 March 2026
Published: 21 April 2026
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