Abstract:

Objective: To investigate the healthcare-seeking delay among students with pulmonary tuberculosis (PTB) in Taian City from 2013 to 2022, identify its determinants, and provide an evidence-based foundation for optimizing tuberculosis prevention and control strategies. Methods: Data were extracted from the Tuberculosis Information Management System, a subsystem of the China Disease Control and Prevention Information System (CDCIS). All student PTB cases in Taian City from 2013 to 2022 were identified based on their registered residence. A total of 656 cases were included, with variables such as sex, ethnicity, educational level, patient source, residential status, household registration, year of diagnosis, and clinical findings. Descriptive statistical analyses were conducted to assess trends in healthcare-seeking delay. Multivariate logistic regression was employed to determine the factors associated with delayed healthcare-seeking behavior. Results: A total of 656 student PTB cases were reported in Taian City from 2013 to 2022. The median (interquartile range) healthcare-seeking delay was 15 (5, 33) days, with an average annual delay rate of 53.96% (354/656). The proportion of delayed healthcare-seeking behavior declined from 62.69% (42/67) in 2013 to 45.61% (26/57) in 2022, although this trend was not statistically significant ( {\chi }_{trend}^2=3.105, P=0.078). Multivariate logistic regression analysis identified passive case detection (OR=1.737, 95%CI: 1.177-2.563) and bacteriologically confirmed TB (OR=1.619, 95%CI: 1.162-2.256) as significant risk factors for delay. Conversely, belonging to an ethnic minority (OR=0.394, 95%CI: 0.155-1.001), urban residence (OR=0.587, 95%CI: 0.419-0.821), and local household registration (OR=0.553, 95%CI: 0.376-0.816) were protective factors against healthcare-seeking delay. Conclusion: Healthcare-seeking delay for PTB among students in Taian City remained persistently high from 2013 to 2022. Passive case detection, bacteriological positivity, residence in non-urban areas, and migrant status were identified as significant risk factors contributing to delayed healthcare-seeking behavior.

Key words: Taian, Students, Tuberculosis,pulmonary, Patient delay, Factor analysis, statistical