| 摘要: |
| 目的 掌握重庆市石柱县结核病流行病学特征及疾病预防与控制中心等结核病定点医疗机构以外的其他各类医疗机构（简称非结防机构）转诊追踪情况，为该县制定结核病防控策略提供参考依据。方法 运用描述性流行病学方法，分析石柱县2005-2014年5 217例结核病患者的资料，并综合评价非结防机构网络直报结核患者或疑似结核患者转诊追踪相关数据。结果（1）石柱县2005-2014年结核年平均患病率为97.17/10万，年平均涂阳率为58.04/10万。（2）5 217例患者中，男性多于女性（χ2=21.900 5，P<0.05），性别比为2.10：1；各类职业中农民构成比最高，占77.42%，其次是学生，占6.40%；各年龄组中，35~44岁组病例数最多，占19.55%，其次是55~64岁组和25~34岁组，分别占16.16%和16.01%。（3）2005-2014年非结防机构网络实报结核患者2 809例，转诊到位1 095例（38.98%），追踪到位578例（20.58%），总体到位1 673 例（59.56%）。转诊到位率从2005年的2.21%大幅度提高到2009年的63.33%，此后从2010年55.64%下降到2014年的33.88%；追踪到位率波动在13.33%~30.54%；（4）1 136例追踪未到位患者中，外出占43.22%，无追踪信息占36.97%，拒绝就诊占10.48%。（5）结防机构对总体到位的1 673例患者进行检查诊断，到位后确诊率为75.13%。确诊涂阳率为64.84%。确诊的活动性结核患者（1 257例）占石柱县同期登记活动性结核患者（5 217例）的24.09%；确诊的涂阳结核患者（815例）占同期登记涂阳结核患者（3 116例）的26.16%。结论 石柱县今后结核病防控工作重点人群为男性、农民，应继续推行结核病防控策略（DOTS），并应重视学生人群的结核预防和治疗工作；同时，加强医防合作对促进转诊追踪情况的落实是结核病疫情控制的关键。 |
| 关键词: 结核 流行病学 转诊 追踪 |
| DOI：10.16781/j.0258-879x.2016.12.1559 |
| 投稿时间：2016-05-05修订日期：2016-07-20 |
| 基金项目: |
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| Epidemiological analysis of tuberculosis and referral and tracking of patients from 2005 to 2014 in Shizhu County, Chongqing |
| LUO Lin1,TAN Yu2,LI Yang1,JIANG He-hong1,Mukagatare Godelieve1,CHEN Yu1* |
(1. School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing 400016, China;
2. Chongqing Shizhu Center for Disease Control and Prevention, Chongqing 409100, China
* Corresponding author) |
| Abstract: |
| Objective To know about the epidemiological characteristics and the referral and tracking situation of tuberculosis(TB) patients in Shizhu County, so as to provide a reference for making TB prevention strategies. Methods The clinical data of 5 217 patients with TB in Shizhu County from 2005 to 2014 were analyzed by descriptive epidemiological methods, and the data of referral and tracking of TB patients and suspects reported from non-tuberculosis organizations were also comprehensively evaluated. Results (1) The annual average prevalence of TB was 97.17/100 000 and the annual average smear-positive rate was 58.04/100 000 from 2005 to 2014 in Shizhu County. (2) There were significantly more males than females in our investigation(χ2=21.900 5,P<0.05), with the sex ratio being 2.10:1. The proportion of farmers were the highest among all the professions, accounting for 77.42%, followed by students, accounting for 6.40%. Patients of 35-44 years old was the largest population, accounting for 19.55%, followed by those of 55-64 and 25-34 years old groups, accounting for 16.16% and 16.01%, respectively. (3) Non-tuberculosis organizations reported 2 809 cases from 2005 to 2014, and the overall arrival was 1 673 cases (59.56%), including referral in 1 095 cases (38.98%) and tracking in 578 cases (20.58%). The rate of referral increased from 2.21% in 2005 to 63.33% in 2009, and then decreased from 55.64% in 2010 to 33.88% in 2014. The rate of tracking fluctuated between 13.33% and 30.54%; (4) 1 136 cases did not arrive after tracking, with going out accounting for 43.22%, no tracking information accounting for 36.97% and refusing treatment accounting for 10.48%. (5) Positive rate and confirmed smear-positive rate were 75.13% and 64.84% in 1 673 arrived cases, respectively. Patients diagnosed with active TB (1 257 cases) accounted for 24.09% of the registered during the same period in Shizhu County (5 217 cases), while diagnosis of smear positive TB in 815 cases accounted for 26.16% of the registered during the same period (3 116 cases). Conclusion The main targets of TB prevention in Shizhu County should be males and farmers. Besides, the DOTS should be continually carried out, and the TB prevention and treatment of students should be emphasized. Meanwhile, the key for TB prevention is the combination of treatment and prevention and implementation of referral and tracking. |
| Key words: tuberculosis epidemiology patient transfer tracking |
