title: Detection delay of pulmonary tuberculosis patients among migrants in China: a cross-sectional study.
abstract: OBJECTIVE
  1) To explore the characteristics of patient and diagnostic delays among migrant tuberculosis (TB) patients in Shandong, China; and 2) to identify factors associated with patient and diagnostic delays, for the development and improvement of TB control strategy among migrants  in China.
  
  
  METHODS
  A cross-sectional study was conducted in 12 counties of Shandong Province using a semi-structured questionnaire. A total of 314 smear-positive pulmonary migrant TB patients registered with the county TB dispensary of the sampling sites from 1 August 2007 to 31 July 2008  were selected.
  
  
  RESULTS
  Among 314 migrant TB patients, the median patient delay was 10 days, and the median diagnostic delay was 8 days. A quarter of the participants had a patient delay of >22 days and a diagnostic delay of >16 days. Factors affecting detection delay included financial  conditions, health insurance status, working time, patient age, severity of initial symptoms, geographic access to TB-related care and the health facilities first visited.
  
  
  CONCLUSIONS
  Interventions such as expansion of the free service package and education about TB diagnosis among community  health personnel are urgently required for early case detection among migrants.
authors.affiliation: Institute of Social Medicine and Health Services Management, School of Public Health, Shandong University, Jinan, Shandong, China.
authors.forename: C
authors.initials: C
authors.lastname: Zhou
authors.forename: R G
authors.initials: RG
authors.lastname: Tobe
authors.forename: J
authors.initials: J
authors.lastname: Chu
authors.forename: H
authors.initials: H
authors.lastname: Gen
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.forename: L
authors.initials: L
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D004651:Employment; D005260:Female; D005382:Financing, Personal; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009313:National Health Programs; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D011237:Predictive Value of Tests; D012042:Registries; D012111:Residence Characteristics; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D014171:Transients and Migrants / Q000523:psychology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000523:psychology; D055815:Young Adult