Table 1

Studies included in 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

Notes:

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.

PD refers to patient delay and DD refers to diagnostic delay. AOR adjusted odds ratio, CI confidence interval, HR hazard ratio; OR odds ratio.

Li et al.

Li et al. BMC Medicine 2013 11:156   doi:10.1186/1741-7015-11-156

Open Data