北京市学校肺结核自动预警系统运行情况分析  

Analysis on the operation of tuberculosis automated-alert system in schools in Beijing

作　　者：李亚敏[1] 高志东[1] 赵鑫[1] LI Ya-min;GAO Zhi-dong;ZHAO Xin(Department of Prevention and Control of Tuberculosis,Beijing Research Institute for Tuberculosis Control,Beijing 100035,China)

机构地区：[1]北京结核病控制研究所防控科,100035

出　　处：《结核与肺部疾病杂志》2021年第2期150-155,共6页Journal of Tuberculosis and Lung Disease

摘　　要：目的分析北京市《传染病自动预警信息系统》中肺结核预警系统的运行情况,为推动其更好的应用提供依据。方法从《传染病自动预警信息系统》中导出北京市2018年7月至2020年12月预警系统产生的肺结核预警信息,包括肺结核预警信号数量、信号响应情况及响应结果,按照时间分布、地区分布及诊断结果进行分析评价。结果2018年7月至2020年12月北京市《传染病自动预警信息系统》共发出6476条预警信号,响应率为99.98%(6475/6476),24h内响应比例为99.24%(6426/6475),响应时间中位数(四分位数)为0.84(0.23~3.38)h,最终34.02%(2203/6476)的预警信号确定为疑似事件。随着时间的推移,2018—2020年24h内信号响应比例从99.51%(1617/1625)降至99.14%(1967/1984),整体信号响应时间从1.09(0.30,4.60)h缩短至0.75(0.21,2.88)h,疑似事件率从36.31%(590/1625)降至29.12%(578/1985)。预警信号数最多的地区为朝阳区(1219条),海淀区疑似事件率最高(67.19%,723/1076)。随着肺结核诊断级别(由低到高依次为无病原学结果、病原学阴性、病原学阳性、利福平耐药)的提高,预警信号数从4519条减少到57条,其中病原学阴性肺结核疑似事件率最高,为35.69%(439/1230)。北京市肺结核预警系统中学校肺结核聚集性疫情阳性预测值为0.23%(15/6476),敏感度为46.88%(15/32)。结论北京市肺结核预警信号响应率及响应及时性较好,但仍存在需要改进的方面,区级结核病防治机构需提高预警系统填报的准确性,进一步提高预警信息处置的质量。Objective To analyze the current operation status of automated-alert system for tuberculosis in schools in Beijing,and to provide a basis for further improving the application of the system.Methods The information of early warning of tuberculosis from July 2018 to December 2020 was derived from the Automated-alert System for Tuberculosis,including the number of early warning signals,response and response results of the early warning signals of tuberculosis,and was analyzed and evaluated according to the temporal distribution,regional distribution and diagnosis results.Results A total of 6476 warning signals were issued by Automated-alert System for Tuberculosis from July 2018 to December 2020 with a signal response rate of 99.98%(6475/6476),and 99.24%(6426/6475)of signals were responded in 24 hours.The median responding time was 0.84 hours(Q1-Q3:0.23-3.38 h),finally 34.02%(2203/6476)early warning signals were identified as suspected events.As time went by,the proportion of signal response decreased from 99.51%(1617/1625)to 99.14%(1967/1984),the overall signal response time decreased from 1.09(0.30,4.60)h to 0.75(0.21,2.88)h,and the suspected event rate decreased from 36.31%(590/1625)to 29.12%(578/1985).Chaoyang District had the largest number of warning signals(1219),and Haidian District had the highest suspected incident rate(67.19%,723/1076).With the improvement of the diagnostic level of pulmonary tuberculosis(from low to high,followed by no etiological results,etiological negative,etiological positive,rifampicin resistance),the number of early warning signals decreased from 4519 to 57,in which the suspected event rate of etiological negative pulmonary tuberculosis was the highest,which was35.69%(439/1230).The positive predictive value and sensitivity of school tuberculosis outbreak epidemic was 0.23%(15/6476)and 46.88%(15/32).Conclusion The Automated-alert System for Tuberculosis in Beijing has a high response rate and response timeliness,but still has room to improve.District level tuberculosis prevention an

关 键 词：结核 肺 学校 预警 北京市 

分 类 号：R521[医药卫生—内科学] R181.8[医药卫生—临床医学]