Detection delay of pulmonary tuberculosis patients among migrants in China: a cross-sectional study

OBJECTIVES: 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. DESIGN: 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.