Zhonghua Liu Xing Bing Xue Za Zhi. 2026 Sep 10;47(9):1637-1643. doi: 10.3760/cma.j.cn112338-20260311-00157.
ABSTRACT
Objective: To analyzes the current status of delayed medical consultation and influencing factors in pulmonary tuberculosis (TB) patients aged ≥65 years in Henan Province from 2020 to 2024, and provide scientific evidence for the improvement of the prevention and control of pulmonary TB in the elderly. Methods: The information were collected from the Tuberculosis Information Management Subsystem of Chinese Information System for Disease Control and Prevention. Study participants were pulmonary TB patients aged ≥65 years who were registered and managed in Henan from January 1, 2020, to December 31, 2024. A retrospective epidemiological survey was conducted to collect information of elderly pulmonary TB patients with delayed medical consultation to understand the distribution and temporal variation trends of those with delayed medical consultation, and χ2 test and multivariate logistic regression model were used to identify the influencing factors of delayed medical consultation. Results: A total of 50 031 elderly pulmonary TB patients were included, in whom 26 783 had delayed medical consultation, with an overall delayed consultation rate of 53.53%. The median time (Q1, Q3) of delayed consultation was 16.0 (4.0, 37.0) days. The delayed consultation rate remained stable at 50.49%-50.94% from 2020 to 2022, then increased rapidly to 55.97% in 2023 and 58.41% in 2024, showing an accelerating upward trend (trend χ2=193.65, P<0.001). In terms of regional distribution, the delayed consultation rate was lowest in Zhumadian (32.00%) and highest in Luohe (77.27%), the difference was significant (χ2=2 428.79, P<0.001). Multivariate logistic regression analysis revealed that the risk factors for delayed medical consultation included jobless/unemployment (aOR=1.24, 95%CI: 1.14-1.36), direct hospital visit (aOR=3.86, 95%CI: 3.07-4.85), referral (aOR=3.45, 95%CI:2.75-4.34), follow-up (aOR=4.31, 95%CI: 3.42-5.42), no complication (aOR=2.15, 95%CI:1.97-2.35), recurrence (aOR=1.30, 95%CI: 1.22-1.39), return visit (aOR=1.84, 95%CI:1.01-3.33), and lack of etiological results (aOR=1.99, 95%CI: 1.29-3.06). Conversely, protective factors were being man (aOR=0.93, 95%CI: 0.89-0.97), population at low risk (aOR=0.59, 95%CI: 0.53-0.65), and non-floating population (aOR=0.89, 95%CI: 0.82-0.96). Conclusions: The rate of delayed medical consultation in elderly pulmonary TB patients in Henan remained stable from 2020 to 2022, then increased rapidly in 2023 and 2024, with an unbalanced regional distribution. More attention should be paid to the early detection of elderly pulmonary TB, especially in women, farmers, floating population, cases identified by passive screening (direct hospital visit, referral and follow-up), those have recurrent illness or lack etiological test results. It is suggested to effectively conduct digital chest radiography screening for the elderly population in combination with basic public health services and strengthen the full-course management and regular follow-up of recurrent patients.
PMID:42763193 | DOI:10.3760/cma.j.cn112338-20260311-00157