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Table 1 Studies included in systematic review and meta-analysis

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

Studies

Type of study

Place of studies

Participants

Residence (rural/urban)

Sample size

Outcome

Risk factors

Zhang 2006 [14]

CS

Hunan Province

New SP PTB

Rural

318

DD (>2 weeks)

PD: No haemoptysis (OR (95% CI): 0.119 (0.041, 0.344)), distance to health facility (OR (95% CI): 24.73 (6. 872, 58. 56)), seeking care from traditional medicine providers (OR (95% CI): 14.39 (4.379, 47.30)), poverty (OR (95% CI): 23.53 (8.389, 65.96))

PD (>2 weeks)

DD: Being female (OR (95% CI): 3.06 (1.412, 6.645)), low education (OR (95% CI): 0.57 (0.370, 0.794)), limited access to TB education (OR (95% CI): 0.45 (0.218, 0.534)), seeking care from traditional medicine providers (OR (95% CI): 2.42 (1.057, 5.536)), seeking prescription from herbalist (OR (95% CI): 2.53 (1.261, 5.077)), and stigma (OR (95% CI): 14.65 (6.217, 31.78)).

Xi 2011 [20]

CS

Shandong Province

PTB

Rural

819

DD (>2 weeks)

DD: First consultation with traditional medicine providers

He 2009 [21]

CS

Hebei Province

New SP PTB

migrants from Rural

168

PD (>2 weeks)

PD: Low education level (P <0.05), lack of health insurance (P <0.01)

Huan 2007 [22]

CS

Guizhou Province

New PTB

Rural/urban

200

PD (>2 weeks)

PD: Distance to health facility;

DD (>2 weeks)

DD: Poor equipment in health facility, health worker’s poor TB awareness and knowledge, poor referral

Wu 2008 [23]

CS

Anhui Province

New SP PTB

Rural/urban

148

PD (>2 weeks)

PD: Poor TB awareness

DD (>2 weeks)

DD: Lack of equipment and qualified health workers in township hospital.

Wang 2007 [34]

CS

Shanghai

New SP/SN PTB

No description

222

PD was defined as the duration from the onset of symptoms to the first visit to a doctor in a hospital.

PD: Low income level (OR (95% CI): 3.859 (1.040, 14.314) for Level 1/level 4, 5.369 (1.717, 16.787) for Level 2/level 4), without Haemoptysis (OR (95% CI): 0.347 (0.127, 0.948))

Bai 2004 [35]

CS

Yunnan Province

New/re-treatment SP/SN PTB

Rural/urban

142

PD (>2 weeks)

PD: Being male (P = 0.037), with spouse (P = 0.010), no hemoptysis (P = 0.035);

DD (>2 weeks)

DD: No night swear (P = 0.030) and chest pain (P = 0.042), respiratory difficulty (P = 0.029), no timely referring (P = 0.001).

Liao 2009 [36]

CS

Zhejiang Province

New SP PTB, elderly

Rural

210

PD (>2 weeks)

PD: Female (P = 0. 018), lack of TB knowledge (P = 0.003), Low access to health facility (P = 0.009)

Yang 2010 [37]

CS

Hujian, Henan, Liaoling, Xinjiang Province

PTB

Rural

888

PD (>2 weeks)

PD: Being female, the elderly, lack of TB knowledge, poverty and traffic difficulty

Zhou 2009 [38]

CS

Henan Province

New PTB

No description

102

PD (>2 weeks)

PD: Poor TB awareness; poverty, traffic difficulty;

DD (>2 weeks)

DD: Consulting with traditional medicine providers first

Li 2002 [39]

CS

Hunan Province

New SP PTB

Rural/urban

3275

PD (>2 weeks)

PD: Being male (P = 0. 003), 30 to 44 years old (P = 0. 009), poor TB awareness, poverty, traffic difficulty;

DD (>2 weeks)

DD: 30 to 44 years old (P = 0. 0001), poor TB knowledge, without smear test in county hospital

Shi 2006 [40]

CS

Liaolin, Hujian, Xingjiang, Henan Province

New SP PTB

No description

186

DD (>2 weeks)

DD: Consulting traditional medicine providers first, no resource for TB diagnosis

Yu 2007 [41]

CS

Anhui Province

New SP PTB

Rural/urban

17873

PD (>2 weeks)

PD: Being female (P <0.05), Rural area;

DD (>2 weeks)

DD: Rural and diagnosed in non-TB hospital, no resource for TB diagnosis

Zhang 2011 [42]

CS

Jiangsu Province

New SP PTB

Rural/urban

276

DD (>2 weeks)

DD: Consulting with traditional medicine providers first, no resource for TB diagnosis

Cai 2007 [43]

CS

Gansu Province

New/retreatment SP/SN PTB

Rural

150

PD (>2 weeks)

PD: The elderly, female, low income, and education level, poor TB knowledge

Chai 2008 [44]

CS

Henan Province

New SP PTB

Rural/urban

200

PD (>3 weeks)

PD: Poor TB awareness, no severe symptoms, busy with work and poverty; stigma for the female

DD (>2 weeks)

DD: Misdiagnosis, no severe symptoms

Tian 2001 [45]

CS

Shangdong Province

PTB, the youth

No description

400

PD (>2 weeks)

PD: Knowledge of TB control unit and TB awareness

DD (>2 weeks)

DD: No haemoptysis (OR (95%): 0.52 (0.27, 0.98)), night swearing (OR (95%): 0.44 (0.23, 0.85)), chest pain (OR (95%): 2.15 (1.12, 4.15)).

Yang 2011 [46]

CS

Jiangsu Province

New SP PTB

No description

105

PD (>2 weeks)

PD: Poor TB awareness, low income level, distance to health facilities

Cao 2002 [47]

CS

Shangdong Province

PTB,

migrants from Rural

314

PD (>2 weeks)

PD: Busy at with work (working more than 6 days per week) (OR (95% CI):6. 70 (2. 80, 16.03)), no health insurance (OR (95% CI): 2.27 (1.07, 4.82)), distance to health facility (OR(95% CI): 2.13 (0.73, 6.18)), no hemoptysis (OR(95% CI): 0. 30 (0. 10, 0. 91)),

Geng 2010 [48]

CS

Shangdong Province

New SP PTB

Rural

200

PD was defined as the duration from the onset of cough to the first visit to any healthcare provider

PD: Poor TB awareness, low income level, lack of knowledge of TB control unit (F = 4.39, P <0.01)

Shi 2008 [49]

CS

Shangdong Province

New SP TB

Rural

312

PD was defined as the time (in days) from the onset of symptoms to first seeking care at a health facility

PD: Aged 40 to 59 (Adjusted HR (95% CI):0.34 (0.17, 0.69)), low education (Adjusted HR (95% CI): 1.91 (1.16, 3.14)), distance to health facility (Adjusted HR (95% CI): 1.04 (0.98, 1.11))

DD: Being female (Adjusted HR (95% CI):0.63 (0.43,0.92)), Consulting with traditional medicine providers first (Adjusted HR (95% CI):1.14 (0.52, 2.51))

Cheng 2005 [50]

CS

Shanghai, Guangdong, Jiangsu Province

New PTB

migrants

323

PD (≥10 days)

PD: Busy with work (AOR (95% CI):1.61 (1.03, 2.51)), no hemoptysis (AOR (95% CI): 0.48 (0.28 ,0.85))

Li 2012 [51]

CS

Shanghai, Guangdong and Jiangsu

new PTB

migrant from rural

323

Patient delay ≥10 days

Average monthly working days ≥24, and without hemoptysis or bloody sputum

Lin 2008 [52]

Cohort

Yunnan Province

SP TB,

Rural

10356

PD (≥60 days)

PD: Geographical barrier, age >40, low income level (Adjusted HR (95%): 0.61 (0.57, 0.65), 0.78 (0.67, 0.90), 0.90 (0.85, 0.94)).

Zhang 2008 [53]

CC

Jiangsu Province

Newly SP PTB elderly

No description

102

PD (>2 weeks)

PD: Poor Tb awareness

DD (>2 weeks)

DD: Misdiagnosis

Hou 2001 [54]

CS

Hubei Province

New SP PTB

No description

823

PD (>2 weeks)

PD: Poor TB awareness, and low income level

DD (>2 weeks)

DD: Consulting with traditional medicine providers first

Liu 2000 [55]

CS

Hunan Province

SP PTB,

Rural/urban

290

PD (>2 weeks)

PD: Poor TB awareness and knowledge;

DD (>2 weeks)

DD: Misdiagnosis, poor referral, not prescribing smear test

Li 2010 [56]

CS

Shandong Province

PTB, elderly

Rural/urban

322

PD (>2 weeks)

PD: 61 to 65 years old and lower income level

Lian 2003 [57]

CS

Guangzhou Province

Newly SP PTB

No description

117

PD (>2 weeks)

PD: Poor TB awareness, low income level, busy with work, traffic barrier.

DD (>2 weeks)

DD: Consulting with traditional medicine providers first

  1. Notes:
  2. CS refers to cross-sectional study and CC refers to case-control study. SP refers to smear positive and SN refers to smear negative. PTB refers to pulmonary tuberculosis.
  3. PD refers to patient delay and DD refers to diagnostic delay. AOR adjusted odds ratio, CI confidence interval, HR hazard ratio; OR odds ratio.