Pulmonary tuberculosis diagnosing and reporting in different type of medical and health institutions in Guiyang, Guizhou, 2016−2020

  Objective  To analyze the reporting cards of pulmonary tuberculosis (TB) reported by medical and health institutions in Guiyang of Guizhou province, understand the characteristics of pulmonary TB distribution and reporting ,and provide evidence for standardizing TB diagnosis and reporting in medical institutions.

  Methods  Through National Special Reporting System for TB, the incidence data of pulmonary TB in Guiyang from 2016 to 2020 were collected and analyzed by descriptive epidemiology method. The differences among groups were compared with χ² tests.

  Results  A total of 73 661 pulmonary TB cases were reported by 177 medical and health institutions in Guiyang from 2016 to 2020, of which 28085 were confirmed cases, accounting for 38.13% of the total cases. The proportions of confirmed pulmonary TB cases in designated and non-designated medical institutions and general hospitals were 48.32%, 27.10% and 28.10% respectively. There was significant difference in the proportion of the cases diagnosed in designated and non-designated medical institutions (χ²=3510.620, P<0.001). There was also significant difference in the proportions of the cases diagnosed in designated medical institutions and general hospitals (χ²=2671.605, P<0.001). Compared with 2016, the number of the confirmed cases reported by designated medical institutions showed an increasing trend (trend χ²=41.917, P<0.001). However the proportions of the confirmed cases reported by non-designated medical institutions and general hospitals showed downward trends (trend χ²=1099.635, P<0.001; trend χ²=748.328, P<0.001). In reported pulmonary TB cases, 49 345 were local residents in Guiyang (66.98%) and 24316 were non- local residents (33.01%). The pulmonary TB cases in local residents were mainly reported by county-level designated medical institutions (17113 cases, 34.68%) and general hospitals (15713 cases, 30.75%), the pulmonary TB cases in non-local residents were mainly reported by general hospitals (11403 cases, 46.90%) and municipal-level designated medical institutions (9747 cases, 40.08%). From 2016 to 2020, the number of the patients who visited municipal designated hospitals in local and non-local residents increased year by year. The registration management rate of the local and non-local cases were 75.57% and 47.23%. The difference was significant (χ²=2098.567, P<0.001). The registration management rates of pulmonary TB cases in different urban areas of Guiyang were different, it was highest (82.81%) in the far urban area, followed by the near urban area (70.66%) and main urban area (66.66%). During 2016−2020, the registration and management rate of the cases were significantly improved in the main urban area (trend χ²=572.661, P<0.001), but it showed a downward trend in the near urban area (trend χ²=65.287, P<0.001), and remained stable in far urban area.

  Conclusion  Medical and health institutions at all levels should strengthen the capacity building of pulmonary TB diagnosis, strengthen technical training to improve the diagnosis and treatment of pulmonary TB; At the same time, health education about pulmonary TB prevention and control should be continued, the patient compliance should be improved and the treatment and management of pulmonary TB cases should be standardized.