Objective  To systematically review the rate of delayed consultation among older pulmonary tuberculosis patients in China. Methods  Databases including Web of Science, PubMed, The Cochrane Library, CBM, CNKI, VIP, and WanFang Data were electronically searched to collect cross-sectional studies on the incidence of delayed consultation in older patients with tuberculosis in China from January 2000 to August 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed by Stata 15.0 software. Results  In total, 76 cross-sectional studies with 461 896 cases involving 321 411 elderly delayed consultation tuberculosis patients were included. The results of meta-analysis showed that the rate of delayed consultation was 55.1% (95%CI 52.0% to 58.1%) in older Chinese adults with tuberculosis. The results of the subgroup analysis showed that the delayed consultation rate of male tuberculosis patients was 57.1% and that in female tuberculosis patients was 60.3%. The delayed consultation rates of patients from the eastern, central, western, and northeastern regions were 54.1%, 58.0%, 56.0%, and 53.3%, respectively, and those of patients aged 60 to 69, 70 to 79, and 80 years or older were 73.1%, 76.8%, and 78.1%, respectively. The delayed consultation rates of tuberculosis patients with illiteracy, primary school education, junior high school education, and above were 50.0%, 56.0%, and 53.4%, respectively. The delayed consultation rates of the patients in the papers published between 2000 and 2005, 2006-2010, 2011-2015, and 2016-2021 were 39.3%, 53.3%, 58.3%, and 54.4%, respectively. Among the different detection methods, the delayed consultation rates of tuberculosis patients due to symptoms or recommendations, referrals, follow-ups, and other detection methods were 72.9%, 69.0%, 73.4%, and 57.2%, respectively. Regarding treatment classification, the delayed consultation rates of initial treatment and the retreatment of pulmonary tuberculosis were 72.3% and 75.2%, respectively. The delayed consultation rates of pulmonary tuberculosis patients with negative and positive etiological examinations were 73.9% and 65.2%, respectively. The delayed consultation rates of farmers and non-farmers with pulmonary tuberculosis were 74.3% and 71.8%, respectively. Conclusion  The incidence of delayed consultation among older tuberculosis patients in China remains high and shows a fluctuating upwards trend. Additionally, there are substantial differences in the rates of delayed consultation by gender, age, geographical location, educational level, discovery method, occupation, and so on.

Citation： LIAO Xiaogang, TAN Jiarong, WU Qiao, SONG Ping. Rate of delayed consultation among older pulmonary tuberculosis patients in China: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2022, 22(5): 558-567. doi: 10.7507/1672-2531.202201031 Copy