Effect of active screening of pulmonary tuberculosis in the elderly in rural area in Quzhou, Zhejiang

  Objective  To analyze the effect of active pulmonary tuberculosis screening in rural elderly population in Quzhou, Zhejiang province.

  Methods  In 2020, chest digital radiography (DR) was conducted in the health examination for the elderly who were aged ≥65 years and had local residence for consecutive 6 months in 89 townships of 6 counties (districts) of Quzhou. The suspected pulmonary TB cases by the examination were referred to designated hospitals for diagnosis. The information about active screening and case survey were collected to understand the coverage of the active screening and the detection rate of pulmonary TB in elderly population.

  Results  In 2020, a total of 311 385 persons met the requirements for health examination, in whom 187 065 received health examination, and 186 096 completed health examination and chest DR. The screening rate was 59.76% (186096/311385), and the screening rate was higher in women (64.22%, 98652/153606) than in men (55.42%, 87444/157779), the difference was significant (χ²=2507.786, P=0.001). The screening rate was highest in age group 70– years (82.82%) and lowest in age grtoup ≥85 years (37.95%), and showed a downward trend with age, the difference was significant (trend χ²=6510.086, P=0.001); The screening rate was highest in Changshan county (80.75%, 30199/37396) and lowest in Kecheng district (35.47%, 21596/60889), the difference was significant (χ²=46983.142, P=0.001). A total of 174 active pulmonary tuberculosis cases were detected with a detection rate of 93.50/100 000 (174/186096), and the detection rate was significantly higher in men (160.10/100 000, 140/87444) than in women (34.46/100 000, 34/98652), the difference was significant (χ²=78.331, P<0.001). The detection rate was highest in Changshan county (175.50/100 000, 53/30199) and lowest in Longyou county (28.97/100 000, 8/27613), the difference was significant (χ²=39.904, P=0.001). The differences in detection rate among different age groups had no significance (χ²=1.775, P=0.777).

  Conclusion  The active screening of pulmonary TB by chest DR in rural elderly in their health examination can be widely used in areas with high incidences of pulmonary TB, but the screening rate and detection rate need to be increased, and the screening strategy need to be improved according to the high-risk factors in local population.