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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(χ~2=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。
Objective To master the epidemiological characteristics of tuberculosis in Shizhu County of Chongqing Municipality and the referral and follow-up of other types of medical institutions (including non-TB control institutions) other than TB medical institutions, such as the Centers for Disease Control and Prevention, providing the prevention and control strategies for tuberculosis in this county Reference. Methods Descriptive epidemiological methods were used to analyze the data of 5 217 tuberculosis patients in Shizhu from 2005 to 2014. The data of referral and follow-up were collected by non-TB prevention and control institutions directly or indirectly. Results (1) The average prevalence rate of tuberculosis in Shizhu from 2005 to 2014 was 97.17 / 100 000, with an average annual rate of 58.04 / 100 000. (2) Among 5 217 patients, there were more males than females (χ ~ 2 = 21.900 5, P <0.05), and the sex ratio was 2.10:1. The percentage of peasants in all occupations was the highest, accounting for 77.42%, followed by students, Accounting for 6.40%. Among all age groups, 35-44 cases accounted for 19.55%, followed by 55-64 years old and 25-34 years old group, accounting for 16.16% and 16.01% respectively. (3) In 2005-2014, there were 2 809 tuberculosis cases reported by the network of non-TB prevention and control institutions, with 1 095 cases (38.98%) being referrals, 578 cases (20.58%) being traced and 1 673 cases (59.56%) overall. The referral rate rose sharply from 2.21% in 2005 to 63.33% in 2009, and then dropped from 55.64% in 2010 to 33.88% in 2014; the catch-up rate fluctuated between 13.33% and 30.54%; (4) 1 136 Cases of follow-up of patients not in place, outgoing accounted for 43.22%, no tracking information accounted for 36.97%, rejected the treatment accounted for 10.48%. (5) The prevention and treatment institutions carried out examination and diagnosis on the 1 673 patients who were in place overall, and the diagnosis rate was 75.13% after they were put in place. Positive smear rate was 64.84%. The number of confirmed active TB patients (1 257 cases) accounted for 24.09% of the total number of active TB patients (5 217 cases) registered in Shizhu County; the positive smear-positive TB patients (815 cases) accounted for smear-positive tuberculosis patients (3 116 cases ) Of 26.16%. Conclusions In the future, the key population of tuberculosis prevention and control in Shizhu County should be men and peasants. DOTS should continue to be implemented and tuberculosis prevention and treatment should be emphasized in the student population. At the same time, it is necessary to strengthen cooperation between medical prevention and prevention in promoting referral and follow-up The implementation of TB control is the key to epidemic control.