Objective  To systematically evaluate the related factors with healthcare-seeking delay in patients with tuberculosis in China from 2014 to 2024, and to provide evidence for the prevention and control of tuberculosis in China.

Methods  CNKI, VIP, WanFang Database, CBM, PubMed, Embase, Web of Science and the Cochrane Library were systematically searched to collect studies on the influencing factors of healthcare-seeking delay in patients with tuberculosis in China from the inception of the databases to April 16, 2025. Stata14.0 software was used for Meta-analysis.

Results  A total of 48 articles were included, including 1 058 577 patients and 25 independent related factors. The results of Meta-analysis showed that demographic characteristics such as age ≥60 years (OR=1.36, 95%CI: 1.27-1.45), female (OR=1.11 ,95%CI: 1.06-1.16), ethnic minority (OR=1.13, 95%CI: 1.04-1.22), junior high school education or below (OR=3.17, 95%CI: 1.20-8.38), living in rural areas (OR=1.38, 95%CI: 1.24-1.55), migrant population (OR=1.29, 95%CI: 1.15-1.45); clinical characteristics such as comorbidities (OR=1.20, 95%CI: 1.09-1.31), co-infection with other forms of tuberculosis (OR=1.54, 95%CI: 1.31-1.81), retreatment (OR=1.17, 95%CI: 1.06-1.30); diagnostic results such as bacteriological positivity (OR=1.28, 95%CI: 1.18-1.40), positive sputum test (OR=1.44, 95%CI: 1.10-1.88); passive discovery methods such as symptom-based visit (OR=3.53, 95%CI: 2.96-4.21), symptom-based recommendation (OR=2.98, 95%CI: 2.74-3.25), referral (OR=2.53, 95%CI: 2.13-3.02) and follow-up (OR=3.20, 95%CI: 2.75-3.73); as well as the occupation of being a farmer (OR=1.39, 95%CI: 1.32-1.46), were the risk factors for healthcare-seeking delay among tuberculosis patients in China. Hemoptysis (OR=0.37, 95%CI: 0.23-0.59), being aware of the core information on tuberculosis prevention and treatment (OR=0.57, 95%CI: 0.42-0.76), active case-seeking (OR=0.38, 95%CI: 0.20-0.70), and occupations such as workers (OR=0.70, 95%CI: 0.55-0.89), students or children (OR=0.70, 95%CI: 0.59-0.81), homemakers and unemployed individuals (OR=0.81, 95%CI:0.76-0.86) were the protective factors.

Conclusion  In recent years, there are many and complex factors affecting the healthcare-seeking delay in patients with tuberculosis in China. In the future, comprehensive measures should be taken targeting influencing factors such as demographic characteristics, clinical characteristics, diagnostic results, patient sources, and occupations to improve the status of healthcare-seeking delay.

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