Chongqing City, The Floating Population And Resident Population Of Tb Patients Suspected Of Treatment Delay And Influencing Factors

Objective: The study aims at understanding the health seeking delay and it's extent among migrant tuberculosis(TB) suspects and resident TB suspects in Chongqing City, in order to identify the factors influencing health seeking delay and compare the differences of those factors between the rural-to-urban migrants and permanent residents, and to provide recommendations to improve policies of TB control in China. Methods: We chosen two districts (both have high proportion of migrants but one developed while the other less developed), in which we classified health facilities into 3 levels according to their amount of patients and randomized picked out 10 ones. From Oct 2004 to Jan 2005, we carried out questionnaires survey on TB suspects above 15 years old, and interviewed with officers in health bureau, CDC, doctors in hospital and TB suspects within the two districts. Results:A total of 590 suspect tuberculosis patients were surveyed and 16 key informants of health bureau, health facilities, doctors and suspect tuberculosis were interviewed by qualitative methods. The median of health seeking delay was 19 days, counterpart of permanent resident and rural to urban migrants is 15 days and 22.5 days, respectively. Attitude to sickness, engaged with director or busyness, Engel index, culture degree, TB history, permanent or migrant, distance from health facility, medical guarantee, gender and marriage status were the factors influencing health seeking. Conclusion: it was found that the delay of health seeking of TB suspects was quite serious, and the factors involved desire of health seeking, occupation, educational, TB history, Engel Index, distance between home and health facility, medical insurance, gender and marital status. To decrease the health seeking delay, it is necessary to take some integrated measures as follows: improving TB control awareness, enlarging the coverage of medical insurance, developing economy, increasing family income, upgrading living level, decreasing Engel Index, providing more help to the poor, strengthening health education, adjusting the distribution of health facilities, raising women's social status, and decreasing the divorce rate, Etc. All mentioned above will reduce the delay of TB suspects and improve TB control.