title: Delays in care seeking, diagnosis and treatment among pulmonary tuberculosis patients in Shenzhen, China.
abstract: BACKGROUND
  Continued improvements in early diagnosis and treatment are critical in the management of tuberculosis (TB).
  
  
  OBJECTIVE
  To assess delays in care seeking, diagnosis and treatment among TB patients in the city of Shenzhen, China, and to explore factors associated with delay.
  
  
  METHODS
  A total of 4677 TB patients were diagnosed and treated under the TB information management system in 2009 and 2010 in Bao'an District, Shenzhen, China. Multivariate logistic regression was used to analyse factors associated with delay among TB patients.
  
  
  RESULTS
  The median time from onset of cough and sputum to the first medical visit was 10 days (range 0-2530); from the first medical visit to TB diagnosis it was 2 days (range 0-2193); and from TB diagnosis to initiation of anti-tuberculosis treatment it was 0 days (range 0-73). On logistic regression, adjusting for other factors, female sex and older age were significantly associated with higher odds of delay in care seeking, first episode of tuberculosis and smear positivity were significantly associated with lower odds of delay in diagnosis, and smear positivity was significantly associated with higher odds of delay in treatment.
  
  
  CONCLUSIONS
  In Bao'an District, Shenzhen, TB is diagnosed and treated in a fairly timely fashion in comparison with reports from other developing countries.
authors.affiliation: Department of Social Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: X
authors.initials: X
authors.lastname: Xu
authors.forename: J-H
authors.initials: JH
authors.lastname: Liu
authors.forename: S-Y
authors.initials: SY
authors.lastname: Cao
authors.forename: Y
authors.initials: Y
authors.lastname: Zhao
authors.forename: X-X
authors.initials: XX
authors.lastname: Dong
authors.forename: Y
authors.initials: Y
authors.lastname: Liang
authors.forename: Z-X
authors.initials: ZX
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D057210:Delayed Diagnosis; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D013183:Sputum / Q000382:microbiology; D013997:Time Factors; D061665:Time-to-Treatment; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D014504:Urban Health; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents