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      Willingness to seek medical care for tuberculosis and associated factors among the elderly population in Shenzhen: a cross-sectional study


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          This study was aimed to assess the willingness of elderly people to seek medical care for tuberculosis (TB) and the associated influencing factors.


          A cross-sectional study.


          A multistage random survey was conducted in Bao’an District of Shenzhen in China.


          A total of 1200 elderly people aged 65 or above were recruited for the study and completed a structured questionnaire between September and October 2019.

          Main outcome measures

          Descriptive and binary logistic stepwise regression analyses were conducted to analyse the characteristics of elderly individuals, their willingness to seek medical care for TB and associated factors.


          Among the final 1123 respondents, 943 (84.0%) were willing to seek medical care if they discovered suspicious TB symptoms. Binary logistic stepwise regression analysis indicated that respondents whose family annual income per capita was 50 000–100 000¥ (OR=2.56, 95% CI: 1.44 to 4.54, p<0.01) and who had positive attitudes (≥3 scores: OR=3.10, 95% CI: 1.90 to 5.05, p<0.01) or practices (≥4 scores: OR=3.13, 95% CI: 1.82 to 5.39, p<0.01) towards TB were more willing to seek medical care for TB.


          Willingness to seek medical care for TB in the elderly population can be improved according to the determinants.

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          Most cited references37

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          Global tuberculosis report 2020.

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            Factors associated with patient, and diagnostic delays in Chinese TB patients: a systematic review and meta-analysis

            Background Delay in seeking care is a major impediment to effective management of tuberculosis (TB) in China. To elucidate factors that underpin patient and diagnostic delays in TB management, we conducted a systematic review and meta-analysis of factors that are associated with delays in TB care-seeking and diagnosis in the country. Methods This review was prepared following standard procedures of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and checklist. Relevant studies published up to November 2012 were identified from three major international and Chinese literature databases: Medline/PubMed, EMBASE and CNKI (China National Knowledge Infrastructure). Results We included 29 studies involving 38,947 patients from 17 provinces in China. Qualitative analysis showed that key individual level determinants of delays included socio-demographic and economic factors, mostly poverty, rural residence, lack of health insurance, lower educational attainment, stigma and poor knowledge of TB. Health facility determinants included limited availability of resources to perform prompt diagnosis, lack of qualified health workers and geographical barriers. Quantitative meta-analysis indicated that living in rural areas was a risk factor for patient delays (pooled odds ratio (OR) (95% confidence interval (CI)): 1.79 (1.62, 1.98)) and diagnostic delays (pooled OR (95% CI): 1.40 (1.23, 1.59)). Female patients had higher risk of patient delay (pooled OR (95% CI): 1.94 (1.13, 3.33)). Low educational attainment (primary school and below) was also a risk factor for patient delay (pooled OR (95% CI): 2.14 (1.03, 4.47)). The practice of seeking care first from Traditional Chinese Medicine (TMC) providers was also identified as a risk factor for diagnostic delay (pooled OR (95% CI): 5.75 (3.03, 10.94)). Conclusion Patient and diagnostic delays in TB care are mediated by individual and health facility factors. Population-based interventions that seek to reduce TB stigma and raise awareness about the benefits of early diagnosis and prompt treatment are needed. Policies that remove patients’ financial barriers in access to TB care, and integration of the informal care sector into TB control in urban and rural settings are central factors in TB control.
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              Tuberculosis and Stigmatization: Pathways and Interventions


                Author and article information

                BMJ Open
                BMJ Open
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                20 September 2021
                : 11
                : 9
                : e051291
                [1 ]departmentDapartment of Tuberculosis Prevention and Control , Shenzhen Bao'an Centre for Chronic Disease Control , Shenzhen, Guangdong, China
                [2 ]departmentDepartment of Social Medicine and Health Management , Huazhong University of Science and Technology Tongji Medical College , Wuhan, Hubei, China
                [3 ]departmentOffice of Tuberculosis Control and Management , Wuhan Institute for Tuberculosis Control, Wuhan Pulmonary Hospital , Wuhan, Hubei, China
                Author notes
                [Correspondence to ] Yong Gan; scswj2008@ 123456163.com ; Xiaojun Wang; wangxiaojun_cn@ 123456163.com
                Author information
                © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                : 17 April 2021
                : 06 September 2021
                Funded by: Scientific Research Fund of Wuhan Municipal Health Commission;
                Award ID: WG19Q03
                Funded by: Health Commission of Hubei Province Scientific Research Project;
                Award ID: WJ2019H400
                Funded by: FundRef http://dx.doi.org/10.13039/501100003819, Natural Science Foundation of Hubei Province;
                Award ID: 2020CFB218
                Funded by: A Major Infectious Disease Prevention and Control of the National Science and Technique Major Project;
                Award ID: 2018ZX10715004
                Infectious Diseases
                Original research
                Custom metadata

                tuberculosis,public health,infection control
                tuberculosis, public health, infection control


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