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Objective <p>To analyze the status of patient delay (PD) and diagnosis delay (DD) and explore factors associated with delays among migrant tuberculosis (TB) patients in suburban Shanghai from 2015 to 2024, aiming to provide a scientific basis for targeted TB control strategies.</p> Methods <p>A retrospective surveillance-based study was conducted using pulmonary tuberculosis (PTB) case data from Fengxian District, Shanghai, obtained from the Tuberculosis Information Management System. Statistical analyses, including the Mann–Whitney U test, chi-square test, multivariable logistic regression, and generalized least squares (GLS) analysis, were performed to examine factors associated with delays. Joinpoint regression was used to analyze temporal trends.</p> Results <p>A total of 3,178 PTB cases (1,573 locals and 1,605 migrants) were included. Compared with locals, migrants exhibited a significantly shorter median PD (8 vs. 11 days; <i>P</i> &lt; 0.001) but a longer median DD (9 vs. 7 days; <i>P</i> &lt; 0.001). Regarding PD, a significant upward trend was observed among migrants from 2017 to 2024 (Annual Percentage Change [APC] = 5.28%, <i>P</i> = 0.015). PD was more likely among female patients, those aged 30–69 years, and those seeking first diagnosis outside Fengxian. DD was less likely among patients seeking first diagnosis outside the district, but more likely among those with negative bacteriological results.</p> Conclusion <p>Migrants in suburban Shanghai are characterized by a pattern of “shorter PD but prolonged DD.” However, the rising trend in PD and the complex effects of cross-district care seeking highlight the urgent need for strengthened inter-district coordination and improved molecular diagnostics at the district level.</p> Clinical trial <p>Not applicable.</p>

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Patient and diagnosis delays among migrant tuberculosis patients in suburban Shanghai, China: a 10-year retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月19日

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  • Zichun Wang,
  • Ziqing Qiao,
  • Lixin Rao,
  • Chunhua Xu,
  • Jing Wang,
  • Zhou Yu,
  • Qing Wang,
  • Weixing Shi,
  • Xin Shen

摘要

Objective

To analyze the status of patient delay (PD) and diagnosis delay (DD) and explore factors associated with delays among migrant tuberculosis (TB) patients in suburban Shanghai from 2015 to 2024, aiming to provide a scientific basis for targeted TB control strategies.

Methods

A retrospective surveillance-based study was conducted using pulmonary tuberculosis (PTB) case data from Fengxian District, Shanghai, obtained from the Tuberculosis Information Management System. Statistical analyses, including the Mann–Whitney U test, chi-square test, multivariable logistic regression, and generalized least squares (GLS) analysis, were performed to examine factors associated with delays. Joinpoint regression was used to analyze temporal trends.

Results

A total of 3,178 PTB cases (1,573 locals and 1,605 migrants) were included. Compared with locals, migrants exhibited a significantly shorter median PD (8 vs. 11 days; P < 0.001) but a longer median DD (9 vs. 7 days; P < 0.001). Regarding PD, a significant upward trend was observed among migrants from 2017 to 2024 (Annual Percentage Change [APC] = 5.28%, P = 0.015). PD was more likely among female patients, those aged 30–69 years, and those seeking first diagnosis outside Fengxian. DD was less likely among patients seeking first diagnosis outside the district, but more likely among those with negative bacteriological results.

Conclusion

Migrants in suburban Shanghai are characterized by a pattern of “shorter PD but prolonged DD.” However, the rising trend in PD and the complex effects of cross-district care seeking highlight the urgent need for strengthened inter-district coordination and improved molecular diagnostics at the district level.

Clinical trial

Not applicable.