曾琼, 张玉, 侯双翼, 笪琴, 卢星星, 皮琦, 杨成凤, 张梦娴, 周丽平. 2019年湖北省肺结核漏登抽样调查及影响因素分析[J]. 疾病监测, 2022, 37(5): 684-688. DOI: 10.3784/jbjc.202109100491
引用本文: 曾琼, 张玉, 侯双翼, 笪琴, 卢星星, 皮琦, 杨成凤, 张梦娴, 周丽平. 2019年湖北省肺结核漏登抽样调查及影响因素分析[J]. 疾病监测, 2022, 37(5): 684-688. DOI: 10.3784/jbjc.202109100491
Zeng Qiong, Zhang Yu, Hou Shuangyi, Da Qin, Lu Xingxing, Pi Qi, Yang Chengfeng, Zhang Mengxian, Zhou Liping. Sampling survey of under-registration of pulmonary tuberculosis and influencing factors in Hubei, 2019[J]. Disease Surveillance, 2022, 37(5): 684-688. DOI: 10.3784/jbjc.202109100491
Citation: Zeng Qiong, Zhang Yu, Hou Shuangyi, Da Qin, Lu Xingxing, Pi Qi, Yang Chengfeng, Zhang Mengxian, Zhou Liping. Sampling survey of under-registration of pulmonary tuberculosis and influencing factors in Hubei, 2019[J]. Disease Surveillance, 2022, 37(5): 684-688. DOI: 10.3784/jbjc.202109100491

2019年湖北省肺结核漏登抽样调查及影响因素分析

Sampling survey of under-registration of pulmonary tuberculosis and influencing factors in Hubei, 2019

  • 摘要:
      目的  了解2019年湖北省肺结核漏登情况的影响因素及原因。
      方法  采用分层随机抽样抽取湖北省(县、市)具有肺结核诊断能力的定点及非定点医疗机构,对其2019年诊断为肺结核和疑似肺结核病例进行调查,评估漏登情况。
      结果  共收集6家医疗机构21 591条信息,最终核查分析肺结核患者3 285例。 2019年湖北省肺结核漏登率为10.23%。 不同诊疗机构属性(χ2=42.933,P<0.001)、机构类型(χ2=6.747,P=0.009)、诊断分类(χ2=18.266,P<0.001)、地区疫情程度(χ2=21.989,P<0.001)及年均门诊量(χ2=24.053,P<0.001)的漏登率不同,差异有统计学意义。 市级漏登风险较高(与县级相比,OR=2.27,95%CI:1.77~2.92),结核性胸膜炎漏登风险较高(相较于利福平耐药肺结核,OR=6.71,95%CI:1.90~23.74)。 追踪未到位和一次性就诊是主要漏登原因。
      结论  关注湖北省肺结核漏登问题,继续提升结核病防治体系服务能力,强化各级医院的规范诊疗服务水平。

     

    Abstract:
      Objective   To understand the under-registration of pulmonary tuberculosis (TB) and analyze the influencing factors and reasons in Hubei province in 2019.
      Methods   A stratified random sampling method was used to select designated and non-designated tuberculosis medical institutions with tuberculosis diagnosis capabilities in counties and cities of Hubei to conduct a survey of registration of pulmonary TB cases and suspected pulmonary TB cases in 2019, and evaluate the status of the under-registration.
      Results   The information of 21591 pulmonary TB cases were collected from 6 medical institutions, finally, the information of 3285 cases were analyzed. In 2019, the under-registration rate of pulmonary TB in Hubei was 10.23%. There were statistically significant differences in under- registration rate among the institutions with different nature (χ2=42.933, P<0.001), institutions of different types (χ2=6.747, P=0.009), cases with different diagnosis classification (χ2=18.266, P<0.001), areas with different epidemic situation (χ2=21.989, P<0.001) and hospitals with different outpatient visits (χ2=24.053, P<0.001). The risk for under-registration of pulmonary TB was higher at city level (compared with the county level, OR=2.27, 95%CI: 1.77−2.92) and in tuberculous pleurisy cases (compared with rifampicin-resistant tuberculosis cases, OR=6.71, 95 %CI: 1.90−23.74). Failure to follow up and one-off visits were the main reasons for the under-registration of pulmonary TB.
      Conclusion   It is necessary to pay attention to the under-registration of pulmonary TB, improve the service capacity of the TB prevention and control system, and strengthen the standardized diagnosis and treatment of pulmonary TB in hospitals in Hubei.

     

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