Abstract:

Objective: To analyze the reporting and case finding delay characteristics of pulmonary tuberculosis patients in Liangping District of Chongqing from 2018 to 2023, and to provide reference for optimizing the prevention and control strategy of pulmonary tuberculosis. Methods: The report data of tuberculosis in Liangping District of Chongqing from 2018 to 2023 were collected from the “Infectious Disease Surveillance System” subsystem of “China Disease Prevention and Control Information System”, and the management data of tuberculosis patients were collected from the subsystem “Tuberculosis Management information System”. Annual percentage change (APC), average annual percentage change (AAPC), monthly percentage change (MPC) and average monthly percentage change (AMPC) were used to analyze the trend of reporting incidence and delay of pulmonary tuberculosis. Results: From 2018 to 2023, the annual reporting incidence of pulmonary tuberculosis in Liangping District of Chongqing decreased from 44.85/100000 (293/653300) to 35.62/100000 (229/642912) and the monthly reporting incidence decreased from 6.43/100000 (42/653300) to 2.64/100000 (17/642917), with a general downward trend (AAPC=-6.005%, 95%CI: -9.877%--2.778%, P<0.001; MPC=AMPC=-0.595%, 95%CI: -0.941%--0.287%, P<0.001). The proportion of passive case finding on pulmonary tuberculosis was 98.10% (1499/1528). The case finding delay rate was 64.54% (404/625), and the delay days (M(Q₁,Q₃)) were 123 (12, 103) days. The diagnosis delay rate was 53.12% (332/625), and the delay days were 49 (9, 52) days. The rate of patient delay was 63.09% (964/1528), and the delay days were 30 (15, 82) days. Only the rate of patient delay fluctuated and decreased in each year (APC=AAPC=-12.918%, 95%CI: -22.311%--5.862%, P<0.001). The rate of patient delay in rural patients (64.96% (658/1013)) was higher than that in urban patients (59.57% (305/512))(χ²=4.238, P=0.040), and rate of patient delay in both showed a decreasing trend (AAPC=-11.447%, 95%CI:-20.166%--5.197%, P<0.001; AAPC=-15.442%, 95%CI: -25.038%--7.358%, P<0.001). Conclusion: The reporting incidence of pulmonary tuberculosis in Liangping District was a fluctuating downward trend. However, the passive case finding of pulmonary tuberculosis patients was the main part, resulting in a higher case finding delay rate and a longer delay time, especially rate of patient delay of township patients was significantly higher than that of urban patients.

Key words: Tuberculosis, pulmonary, Medical care seeking delay, Delayed diagnosis, prevention and control, Epidemiologic study characteristics as topic, Communicable disease control