title: Pulmonary tuberculosis among migrants in Shandong, China: factors associated with treatment delay.
abstract: OBJECTIVE
  A timely initiation of treatment is crucial to better control tuberculosis (TB). The aim of this study is to describe treatment delay among migrant patients with TB and to identify factors associated with treatment delay, so as to provide evidence for strategy development and improvement of TB control among migrants in China.
  
  
  METHODS
  A cross-sectional study was conducted in Shandong province of China. A total of 314 confirmed smear positive migrant patients with pulmonary TB were included. Univariate logistic regression was used to analyse the association of variables with treatment delay among migrant patients with TB. A multilogistic regression model was developed to further assess the effect of variables on treatment delay.
  
  
  RESULTS
  Of 314 migrant patients with TB, 65.6% experienced treatment delay (>1 day). Household income level, diagnosis symptom severity, understanding of whether TB is curable or not and knowledge about the free TB treatment policy are factors significantly associated with treatment delay.
  
  
  CONCLUSIONS
  Economic status and knowledge about TB are key barriers to accessing TB treatment. An integrated policy of carrying out TB-related health education and publicising the free TB treatment policy among migrants is needed. Health insurance schemes for migrants should be modified to make them transferrable and pro-poor.
authors.affiliation: Department of Health Management and Maternal and Child Healthcare, School of Public Health, Shandong University, Jinan, Shandong, China.
authors.forename: Chengchao
authors.initials: C
authors.lastname: Zhou
authors.affiliation: Shandong Centre for Disease Control and Prevention, Jinan, Shandong, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chu
authors.affiliation: Shandong Center for Tuberculosis Prevention and Control, Jinan, Shandong, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Geng
authors.affiliation: Department of Health Management and Maternal and Child Healthcare, School of Public Health, Shandong University, Jinan, Shandong, China.
authors.forename: Xingzhou
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Health Management and Maternal and Child Healthcare, School of Public Health, Shandong University, Jinan, Shandong, China.
authors.forename: Lingzhong
authors.initials: L
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014171:Transients and Migrants; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000208:ethnology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents
keywords: HEALTH SERVICES ADMINISTRATION & MANAGEMENT