Profile and determinants of delayed care-seeking and diagnosis among patients with imported malaria: a retrospective study in China, 2014–2021

作者：Tao Zhang, Duoquan Wang, Yingjun Qian, Wei Ruan, Ying Liu, Jing Xia, Hui Yan, Yuan Sui, Shenning Lu, Xian Xu, Jingjing Jiang, Xiaofeng Lyu, Shuqi Wang, Shi‐Zhu Li, Weidong Li · 发表于：Infectious Diseases of Poverty · 年份：2022 · DOI：10.1186/s40249-022-01050-3 · 被引用次数：17 · 研究领域：Malaria Research and Control、Parasites and Host Interactions、Travel-related health issues

BACKGROUND: In areas where malaria has been eliminated, delayed care-seeking and diagnosis of imported malaria are constant threats. This study aimed to describe the profile and determinants of delayed care-seeking and diagnosis among patients with imported malaria in China. METHODS: This retrospective study assessed surveillance data obtained from 2014 to 2021 in the Chinese provincial-level administrative divisions (PLADs) of Anhui, Henan, Hubei, and Zhejiang, and Guangxi. Epidemiological characteristics were analyzed using descriptive statistics. Furthermore, factors associated with delayed care-seeking and diagnosis among imported malaria cases were identified using multivariate logistic regression. RESULTS: = 11.395, P = 0.001). In multivariate analysis, independent risk factors associated with delayed care-seeking include PLADs (Guangxi as reference), consultations in high-level facilities for the first medical visit, infections with non-Plasmodium falciparum species, and older age. However, PLADs (Guangxi as reference), the purpose of traveling (labour as reference), and infections with non-P. falciparum species increased the risk of delayed diagnosis. Delayed care-seeking (adjusted odds ratio: 1.79, P = 0.001) and diagnosis (adjusted odds ratio: 1.62, P = 0.004) were risk factors for severe disease development. CONCLUSIONS: Based on this study's findings, we strongly advocate for improved access to quality healthcare to reduce the rate of misdiagnosis at the first vis...