Objective: A timely initiation of treatment is crucial to better control tuberculosis (TB). The aim of this study is to describe treatment delay among migrant patients with TB and to identify factors associated with treatment delay, so as to provide evidence for strategy development and improvement of TB control among migrants in China. Design: A cross-sectional study was conducted in Shandong province of China. A total of 314 confirmed smear positive migrant patients with pulmonary TB were included. Univariate logistic regression was used to analyse the association of variables with treatment delay among migrant patients with TB. A multilogistic regression model was developed to further assess the effect of variables on treatment delay. Results: Of 314 migrant patients with TB, 65.6% experienced treatment delay (>1 day). Household income level, diagnosis symptom severity, understanding of whether TB is curable or not and knowledge about the free TB treatment policy are factors significantly associated with treatment delay. Conclusions: Economic status and knowledge about TB are key barriers to accessing TB treatment. An integrated policy of carrying out TB-related health education and publicising the free TB treatment policy among migrants is needed. Health insurance schemes for migrants should be modified to make them transferrable and pro-poor. © 2014, BMJ Publishing Group. All rights reserved.

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education China household sputum smear logistic regression analysis health care policy health insurance human epidemiology middle aged time factor Aged Time Factors Feasibility Studies ethnology knowledge Cross-Sectional Studies Surveys and Questionnaires Young Adult income cross-sectional study migrant Humans lung tuberculosis tuberculostatic agent Antitubercular Agents Adolescent male Tuberculosis, Pulmonary female Socioeconomic Factors risk factor Risk Factors socioeconomics short course therapy questionnaire symptom Incidence Article feasibility study Retrospective Studies patient compliance major clinical study adult migration therapy delay disease severity Transients and Migrants retrospective study