南宁市农村地区TB/HIV双重感染流行特征及随访管理情况分析  

Analysis of Epidemiological Characteristics and Follow-up Management Situation of TB/HIV Co-infection in Rural Areas of Nanning City

作　　者：何波[1] 农丽萍[1] 黎舒[1] 黎火佳 汤洪洋[1] 林倩[1] 姚敏[1] 岑平[1] 陈文才[1] 李斯斯[1] 吴敬兰 覃威翱 HE Bo;NONG Liping;LI Shu;LI Huojia;TANG Hongyang;LIN Qian;YAO Min;CEN Ping;CHEN Wencai;LI Sisi;WU Jinglan;QIN Weiao(Nanning City Center for Disease Control and Prevention in Guangxi,Nanning 530023,China;The Health Supervision Institute of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]南宁市疾病预防控制中心,广西南宁530023 [2]广西壮族自治区卫生监督所,广西南宁530021

出　　处：《中国皮肤性病学杂志》2020年第2期179-185,共7页The Chinese Journal of Dermatovenereology

基　　金：广西卫生和计划生育委员会科研课题(Z20180347,Z20181042,Z20190631,Z2016013);南宁市科技局科研课题(20183039-1)。

摘　　要：目的了解南宁市农村地区结核杆菌/艾滋病病毒(TB/HIV)双重感染(以下简称:双重感染)疫情报告特征及随访管理状况,为制定TB/HIV双重感染防控策略提供科学依据。方法对2018年1-12月南宁市新登记管理的147例农村地区TB/HIV双重感染病例,进行面对面的问卷调查,分析其流行特征及随访管理情况。结果147例双重感染病例中,以男性为主(79.59%),以50岁及以上年龄段(59.86%)、初中及以下文化(94.56%)、已婚有配偶(68.03%)和职业为农民(92.52%)大多数,民族以汉族略多(53.06%);病例主要分布在横县(34.69%)和宾阳县(29.93%);HIV感染途径以异性传播为主(94.56%);结核病患病以单纯肺结核者为多数(92.52%)。2018年内双重感染病例随访检测率较低,仅为82.99%。随访检测率最高的是横县(92.16%),最低的是隆安县(50.00%)(χ~2=15.247,P<0.05)。多因素分析显示,病程阶段为艾滋病(OR=1.321,95%CI:1.213~1.625)、已接受抗病毒治疗(OR=6.821,95%CI:5.962~7.219)是双重感染病例接受随访检测的保护因素(OR>1)。结论文化水平低、已婚有配偶的男性中老年人群是南宁市农村地区双重感染防治工作的重点对象。病例随访检测率较低,应有针对性的开展两种疾病的综合宣传干预,确保病例有效管理和治疗,防止TB/HIV的传播。Objective To analyze the epidemiological characteristics and follow-up management situation of TB/HIV co-infection cases in rural areas of Nanning,and to provide scientific basis for formulating TB/HIV co-infection prevention and control strategies.Methods A face-to-face questionnaire survey was conducted on 147 cases of TB/HIV co-infection newly registered in rural areas of Nanning from January to December 2018.The epidemiological characteristics and follow-up management situation were analyzed.Results The demographic features of 147 cases of TB/HIV co-infection included mainly males(79.59%),aged 50 and above(59.86%),junior middle school and below(94.56%),married spouses(68.03%),and peasants(92.52%)and Han nationality(53.06%).The cases were mainly distributed in Hengxian(34.69%)and Binyang county(29.93%).The main route of HIV infection was heterosexual transmission(94.56%);the majority of tuberculosis cases were simple tuberculosis(92.52%).In 2018,the follow-up testing rate of TB/HIV coinfection cases was low(only 82.99%).The highest follow-up testing rate was Hengxian(92.16%)and the lowest was Longan county(50.00%),and the difference was statistically significant(χ~2=15.247,P<0.05).Multivariate analysis showed that AIDS stage(OR=1.321,95%CI:1.213~1.625)and antiviral therapy(OR=6.821,95%CI:5.962~7.219)were the protective factors for follow-up testing rate(OR>1).Conclusion The middle-aged and elderly men with low educational level and with spouses are the key targets of TB/HIV co-infection prevention and control in rural areas of Nanning.However,the follow-up testing rate is low.Therefore,comprehensive education and intervention should be carried out to ensure effective case management and treatment and to prevent the transmission of TB/HIV.

关 键 词：结核杆菌 艾滋病病毒 双重感染 流行特征 随访管理 

分 类 号：R512.91[医药卫生—内科学] R52[医药卫生—临床医学]