新型冠状病毒肺炎疫情对四川省结核病患者登记情况的影响分析  

The impact of the COVID-19 epidemic on tuberculosis notification in Sichuan Province

作　　者：李婷[1] 何金戈[1] 夏岚[1] 陈闯[1] 肖月[1] 逯嘉[1] 王丹霞[1] LI Ting;HE Jin-ge;XIA Lan;CHEN Chuang;XIAO Yue;LU Jia;WANG Dan-xia(Department of Tuberculosis Prevention and Control,Sichuan Center for Disease Control and Prevention,Chengdu 610041,China)

机构地区：[1]四川省疾病预防控制中心结核病预防控制所,成都610041

出　　处：《中国防痨杂志》2021年第9期929-938,共10页Chinese Journal of Antituberculosis

摘　　要：目的分析2020年新型冠状病毒肺炎(COVID-19)疫情对四川省结核病患者登记情况的影响,为COVID-19常态化防控形势下结核病的发现工作提供参考。方法利用《中国疾病预防控制信息系统》的子系统《结核病信息管理系统》中的结核病病案数据,以2020年1月25日(全国30个省份启动突发公共卫生事件一级响应)全国COVID-19响应和4月8日(武汉重新开放)为时间节点将数据划分为对照期、强化干预期和常态防控期(每期包括11周),以2017—2019年数据作为基线。分析各时期结核病登记例数和病原学阳性率变化情况,疫情暴发前后结核病登记率变化的空间分布,以及疫情期间不同特征结核病患者登记例数同比变化情况。结果 2020年第1季度四川省结核病定点医疗机构接诊的初诊患者例数(22 656例)环比和同比分别下降35.97%(12 730/35 386)和33.94%(11 642/34 298)。强化干预期第1周,结核病患者登记例数下降了62.52%(452/723);结核病患者病原学阳性率从春节前1周的48.27%(349/723)下降至春节后第1周的43.17%(117/271),下降5.10个百分点;登记例数和病原学阳性率恢复到疫情期前的水平分别用了约8周和4周的时间。全省有131个(71.58%,131/183)县(市、区)结核病患者登记例数同比出现下降,98个(53.55%,98/183)县(市、区)结核病患者环比出现下降。男性、学生、汉族、省间流动/港澳台/外籍结核病患者登记例数同比降幅较大,分别下降25.06%(1805/7203)、38.77%(352/908)、25.01%(2088/8348)和38.46%(100/260),且随着年龄增长,登记例数降幅存在上升趋势[<15、15~24、25~34、35~44、45~54、55~64和≥65岁组递降率分别为8.89%(16/180)、26.28%(488/1857)、4.52%(61/1350)、18.68%(203/1087)、24.83%(498/2006)、28.53%(432/1514)和28.57%(558/1953)],差异有统计学意义(Cochran-Armitage趋势检验,Z=2.520,P<0.001)。结论 COVID-19疫情对四川省结核病患者登记情况的短期影响非常明显,患者报告Objective To analyze the impact of COVID-19 epidemic on tuberculosis(TB)case notification in Sichuan Province in 2020,and to provide experience for TB detection under the situation of normalized COVID-19 control. Methods Medical records of TB patients from TB ManagementInformationSystemofChineseDiseases ControlInformationSystem were divided into three phases(control phase,intensive intervention phase and normalized phase,each phase contain 11 weeks)in relation to two time point:national response to COVID-19(January 25,30 provinces launched public health emergency response level 1)and Wuhan reopen(April 8).Data from 2017-2019 were used as baseline.The changes of TB notification number and the percentage of bacteriologically confirmed cases in each phases were analyzed as well as the changes of spatial distribution and characteristics of notified TB patients before and after the epidemic. Results In the first quarter of 2020,the number of visitors in designated TB hospitals(22 656 cases)in Sichuan Province decreased by 35.97%(12 730/35 386)year-on-year and 33.94%(11 642/34 298)quarter-on-quarter.The notification number of TB patients and the percentage of bacteriologically confirmed cases decreased sharply in the 1 st week of the intensive intervention phase by 62.52%(452/723)and5.10%(from 48.27%(349/723)1 week before Sprint Festival to 43.17%(117/271)1 week after),respectively.It took 8 weeks and 4 weeks for these two indicators rebounding to their pre-epidemic levels.Among all 183 counties in the province,131(71.58%)showed a year-on-year decline on notification number and 98(53.55%)showed a quarter-on-quarter decline.The notification number of male,student,Han,inter-provincial migrants,patients from Hong Kong,Macao,Taiwan and foreign countries showed larger year-on-year decline rates(25.06%(1805/7203),38.77%(352/908),25.01%(2088/8348)and 38.46%(100/260)respectively).Also,the notification number among patients under 15,15-24,25-34,35-44,45-54,55-64 and over 65 had declined 8.89%(16/180),26.28%(488/1857),4.52%(61/1

关 键 词：结核 肺 冠状病毒感染 登记 对比研究 

分 类 号：R52[医药卫生—内科学]