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21591条信息,最终核查分析肺结核患者3285例。2019年湖北省肺结核漏登率为10.23%。不同诊疗机构属性(χ^(2)=42.933,P<0.001)、机构类型(χ^(2)=6.747,P=0.009)、诊断分类(χ^(2)=18.266,P<0.001)、地区疫情程度(χ^(2)=21.989,P<0.001)及年均门诊量(χ^(2)=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。
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(χ^(2)=42.933,P<0.001),institutions of different types(χ^(2)=6.747,P=0.009),cases with different diagnosis classification(χ^(2)=18.266,P<0.001),areas with different epidemic situation(χ^(2)=21.989,P<0.001)and hospitals with different outpatient visits(χ^(2)=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.
作者
曾琼
张玉
侯双翼
笪琴
卢星星
皮琦
杨成凤
张梦娴
周丽平
Zeng Qiong;Zhang Yu;Hou Shuangyi;Da Qin;Lu Xingxing;Pi Qi;Yang Chengfeng;Zhang Mengxian;Zhou Liping(Hubei Standardized Training of Public Health Physician Program,Wuhan 430079,Hubei,China;Maojian District Center for Disease Control and Prevention,Shiyan 442012,Hubei,China;Tuberculosis Institute,Hubei Provincial Center for Disease Control and Prevention,Wuhan 430079,Hubei,China)
出处
《疾病监测》
CAS
CSCD
北大核心
2022年第5期684-688,共5页
Disease Surveillance
关键词
结核
肺
漏登
影响因素
监测
Tuberculosis,Pulmonary
Underreporting
Influencing factors
Surveillance
