摘要
目的:分析2018—2023年重庆市梁平区肺结核患者报告情况及发现延迟特征,为优化肺结核防控策略提供依据。方法:从“中国疾病预防控制信息系统”子系统“传染病监测系统”中收集2018—2023年重庆市梁平区肺结核报告数据,从子系统“结核病管理信息系统”中收集肺结核患者管理资料数据,采用年度变化百分比(APC)、平均年度变化百分比(AAPC)、月度变化百分比(MPC)及平均月度变化百分比(AMPC)分析肺结核报告发病率及延迟变化趋势。结果:2018—2023年重庆市梁平区肺结核年报告发病率从44.85/10万(293/653300)下降至35.62/10万(229/642912),月报告发病率从6.43/10万(42/653300)下降至2.64/10万(17/642917),总体均呈下降趋势(AAPC=-6.005%,95%CI:-9.877%~-2.778%,P<0.001;MPC=AMPC=-0.595%,95%CI:-0.941%~-0.287%,P<0.001)。被动发现的肺结核患者所占比例为98.10%(1499/1528)。发现延迟率为64.64%(404/625),延迟时间[M(Q1,Q3)]为123(12,103)d;诊断延迟率为53.12%(332/625),延迟时间为49(9,52)d;就诊延迟率为63.09%(964/1528),延迟时间为30(15,82)d;各年度仅就诊延迟率总体呈波动下降趋势(APC=AAPC=-12.918%,95%CI:-22.311%~-5.862%,P<0.001)。乡镇患者的就诊延迟率[64.96%(658/1013)]高于城区患者[59.57%(305/512)](χ^(2)=4.238,P=0.040),二者各年份的就诊延迟率均呈下降趋势(AAPC=-11.447%,95%CI:-20.166%~-5.197%,P<0.001;AAPC=-15.442%,95%CI:-25.038%~-7.358%,P<0.001)。结论:梁平区肺结核报告发病率呈波动下降趋势,肺结核患者以被动发现为主,导致发现延迟率较高、延迟时间较长,尤其是乡镇患者的就诊延迟率明显高于城市患者。
Objective:To analyze the reporting and case finding delay characteristics of pulmonary tuberculosis patients in Liangping District of Chongqing from 2018 to 2023,and to provide reference for optimizing the prevention and control strategy of pulmonary tuberculosis.Methods:The report data of tuberculosis in Liangping District of Chongqing from 2018 to 2023 were collected from the“Infectious Disease Surveillance System”subsystem of“China Disease Prevention and Control Information System”,and the management data of tuberculosis patients were collected from the subsystem“Tuberculosis Management information System”.Annual percentage change(APC),average annual percentage change(AAPC),monthly percentage change(MPC)and average monthly percentage change(AMPC)were used to analyze the trend of reporting incidence and delay of pulmonary tuberculosis.Results:From 2018 to 2023,the annual reporting incidence of pulmonary tuberculosis in Liangping District of Chongqing decreased from 44.85/100000(293/653300)to 35.62/100000(229/642912)and the monthly reporting incidence decreased from 6.43/100000(42/653300)to 2.64/100000(17/642917),with a general downward trend(AAPC=-6.005%,95%CI:-9.877%--2.778%,P<0.001;MPC=AMPC=-0.595%,95%CI:-0.941%--0.287%,P<0.001).The proportion of passive case finding on pulmonary tuberculosis was 98.10%(1499/1528).The case finding delay rate was 64.54%(404/625),and the delay days(M(Q1,Q3))were 123(12,103)days.The diagnosis delay rate was 53.12%(332/625),and the delay days were 49(9,52)days.The rate of patient delay was 63.09%(964/1528),and the delay days were 30(15,82)days.Only the rate of patient delay fluctuated and decreased in each year(APC=AAPC=-12.918%,95%CI:-22.311%--5.862%,P<0.001).The rate of patient delay in rural patients(64.96%(658/1013))was higher than that in urban patients(59.57%(305/512))(χ^(2)=4.238,P=0.040),and rate of patient delay in both showed a decreasing trend(AAPC=-11.447%,95%CI:-20.166%--5.197%,P<0.001;AAPC=-15.442%,95%CI:-25.038%--7.358%,P<0.001).Conclusion:The reporting incidence of pulmonary tuberculosis in Liangping District was a fluctuating downward trend.However,the passive case finding of pulmonary tuberculosis patients was the main part,resulting in a higher case finding delay rate and a longer delay time,especially rate of patient delay of township patients was significantly higher than that of urban patients.
作者
廖影
庞艳
赵静
何高琴
游茂林
王蕾
Liao Ying;Pang Yan;Zhao Jing;He Gaoqin;You Maolin;Wang Lei(Department of Disease Control and Prevention,Liangping District Center for Disease Control and Prevention,Chongqing 405200,China;District and County Departments of Chongqing Tuberculosis Prevention and Control Institute,Chongqing 400050,China;Department of Epidemiology and Statistics,School of Public Health,Xinjiang Medical University,Urumqi 830000,China;Department of Mathematics,College of Medical Engineering and Technology,Xinjiang Medical University,Urumqi 830000,China)
出处
《结核与肺部疾病杂志》
2025年第1期8-13,共6页
Journal of Tuberculosis and Lung Disease
基金
国家自然科学基金(12061079)
重庆市科卫联合医学科研项目(2024MSXM140)
重庆市梁平区-璧山区协作科研项目(BSKJ2023068)。
关键词
结核
肺
就诊延误
诊断延迟
预防和控制
流行病学研究特征(主题)
传染病控制
Tuberculosis,pulmonary
Medical care seeking delay
Delayed diagnosis,prevention and control
Epidemiologic study characteristics as topic
Communicable disease control
