2009—2018年浙江省<15岁结核病患儿发现延误分析  

Delay in detection of tuberculosis in children under 15 years of age in Zhejiang Province from 2009 to 2018

作　　者：刘魁[1] 吴婷 王伟[1] 彭颖[1] 王飞[1] 何铁牛[1] 柴程良[1] 王晓萌[1] 陈彬[1] LIU Kui;WU Ting;WANG Wei;PENG Ying;WANG Fei;HE Tie-niu;CHAI Cheng-liang;WANG Xiao-meng;CHEN Bin(Zhejiang Provincial Center for Disease Control and Prevention ,Hangzhou 310051 ,China)

机构地区：[1]浙江省疾病预防控制中心结核病预防控制所,杭州,310051 [2]徐州医科大学公共卫生学院

出　　处：《结核病与肺部健康杂志》2019年第2期115-120,共6页Journal of Tuberculosis and Lung Health

基　　金：国家自然科学基金(71640019);浙江省公益技术研究计划(LGF19H260004);浙江省哲学社会科学一般项目(19NDJC243YB);浙江省疾病预防控制中心青年科技创新人才培养项目(20170701);复旦大学公共卫生安全教育部重点实验室开放基金(GW2019-3)

摘　　要：目的了解浙江省<15岁肺结核患儿发现延误情况,为该地区儿童结核病防治的科学决策提供参考依据.方法收集2009-2018年《中国疾病预防控制信息系统结核病信息管理系统》中浙江省<15岁儿童结核病疫情资料,共获得1730例患儿信息,应用Excel2019和SPSS18.0软件对<15岁儿童结核病患者的发现延误进行描述性分析及其潜在影响因素研究.结果1730例<15岁儿童活动性肺结核患者中,发现延误率为44.10%(763/1730).患儿发现时间间隔的中位数(四分位数)[M(Q1,Q3)]为24(12,50)d.患儿就诊时间间隔[M(Q1,Q3)]为18(7,40)d,就诊延误率为55.78%(965/1730).多因素logistic回归分析结果显示:首诊地区、职业、年龄组、诊断结果和诊断分型为发现延误的主要影响因素(Waldx2值为28.586,7.718,6.996,24.064,17.143,P值为0.001、0.052、0.072、<0.001、0.002).结论浙江省<15岁儿童结核病患者中发现延误情况较其他人群严重,首诊地区、职业、年龄、诊断结果和诊断分型等因素和发现延误有关,应该引起各级结核病防治机构的重视.Objective To investigate the case-finding delay of tuberculosis in children aged V15 years in Zhejiang Province, and to provide reference for scientific policy-making of childhood tuberculosis control and prevention. Methods The specific TB case information of the children aged V15 years old was collected from "China In formation System for Disease Control and Prevention Tuberculous Management In formation Systemduring the period of 2009 . 2018. There were a total of 1730 childhood cases included in this study. Descriptive analysis was performed to present the epidemic characteristics of case-finding delay by Excel 2019 software, and SPSS software 1& 0. One-way analysis of variance (X^2) and logistic regression analysis were used to identify the potential influential factors causing the case-finding delay. Results Among the 1730 children cases under 15 years old reported in the 11 "ties of Zhejiang Province, the median delay interval of case finding was 24(12,50) d with delay proportion of 44. 10%(763/1730). The median interval of patient delay time was 18(7,40) d with delay proportion of 55. 78%(965/1730). Multivariate logistic regression analysis showed that the region of first diagnosis, occupation, age group, diagnosis results and diagnosis type play a vital role in the occurrence of finding delay (Wald. value was 2.586,7. 718, 6. 996, 24. 064 and 17.143, P value was 0. 001, 0. 052, 0. 072, V0. 001 and 0. 002). Conclusion The finding delay of tuberculosis among children aged VI5 years was more serious than that of other groups in Zhejiang Province. Region of first diagnosis, occupation, age group, diagnosis results and diagnosis type were associated with finding delay. More attention should be play by all levels of TB control facil.ies.

关 键 词：儿童 结核病 延误诊断 因素分析 统计学 

分 类 号：R529.9[医药卫生—内科学]