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目的通过外来人口肺结核随访监测,了解外来人口肺结核流行特征和诊治延误现状,为探寻降低肺结核患病率的有效措施提供依据。方法 2009—2012年每年对外来人口集中场所和村卫生室开展一次随访监测和健康教育,了解有无肺结核可疑症状者和患者。对辖区内管理的肺结核患者进行户籍地调查,掌握外来人口发病情况。做好疑似病例诊断,收集肺结核专报数据和确诊患者诊疗信息,进行患病率和诊疗延误分析评估,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 4年监测外来人口586 342人,登记肺结核患者383例,其中新涂阳肺结核157例。外来人口肺结核、新涂阳肺结核年均标化患病率分别为84.86/10万、36.50/10万,其中男性肺结核、新涂阳肺结核患病率(分别为:82.59/10万、34.36/10万)均明显高于女性(分别为:42.81/10万、16.89/10万)。农民工为主要患病人群,15~24岁组与≥65岁组患病率相对较高,患者诊疗延误主要发生在就诊阶段,就诊延误率达57.70%,出现可疑症状到就诊平均34.63 d。结论目前外来人口肺结核防控仍不容忽视,年轻民工和老年人应是防治重点对象,需加强针对性宣传教育、主动监测和归口诊治,做到早发现、早诊断、早治疗。
Objective To investigate the prevalence of pulmonary tuberculosis in migrant population and the status of diagnosis and treatment delay by monitoring the follow-up of pulmonary tuberculosis in non-native population and provide evidence for effective measures to reduce the prevalence of pulmonary tuberculosis. Methods From 2009 to 2012, we conducted a follow-up monitoring and health education on migrant population centers and village clinics each year to find out if there are any suspects and patients with tuberculosis. Tuberculosis patients administered within the jurisdiction of the household registration survey to understand the incidence of foreign population. To do a good case diagnosis, collection of tuberculosis special report data and diagnosis of patient diagnosis and treatment information, analysis of the prevalence and treatment delay analysis, count data using χ2 test, P <0.05 for the difference was statistically significant. Results A total of 586 342 migrants were enrolled in the study over the past four years. 383 pulmonary tuberculosis cases were registered, including 157 cases of new smear-positive pulmonary tuberculosis. The annual standardized rates of pulmonary tuberculosis and new smear positive tuberculosis of migrant population were 84.86 / 100 000 and 36.50 / 100 000, respectively. The prevalence rates of male tuberculosis and new smear positive tuberculosis were 82.59 / 100 000 and 34.36 / 10 Million) were significantly higher than females (respectively: 42.81 / 100000, 16.89 / 100000). The prevalence rate of migrant workers was mainly from 15 to 24 years old group and ≥65 years old group. The delay of diagnosis and treatment occurred mainly in the visiting stage. The delay rate of visiting was 57.70% and the suspicious symptom was up to 34.63 days. Conclusion At present, the prevention and control of pulmonary tuberculosis should not be neglected. Young migrant workers and the elderly should be the key targets of prevention and treatment.