2013-2022年嘉兴市儿童青少年肺结核发现延迟分析  

Delay in identification of pulmonary tuberculosis among children and adolescents in Jiaxing City from 2013 to 2022

作　　者：葛锐[1] 田敏 侯志刚 潘维浙 朱国英[1] 冯豪 GE Rui;TIAN Min;HOU Zhigang;PAN Weizhe;ZHU Guoying;FENG Hao(Department of HIV/AIDS,STDS and Tuberculosis Control and Prevention,Jiaxing Center for Disease Control and Prevention,Jiaxing,Zhejiang 314050,China;Nanhu District Center for Disease Control and Prevention,Jiaxing,Zhejiang 314051,China)

机构地区：[1]嘉兴市疾病预防控制中心艾滋病性病结核病预防控制科,浙江嘉兴314050 [2]嘉兴市南湖区疾病预防控制中心,浙江嘉兴314051

出　　处：《预防医学》2023年第12期1089-1092,共4页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：浙江省卫生高层次人才-医坛新秀培养对象资助项目(2021-132)。

摘　　要：目的了解2013-2022年浙江省嘉兴市儿童青少年肺结核发现延迟情况及其影响因素,为制定针对性的防控措施提供参考。方法通过中国疾病预防控制信息系统结核病管理信息系统收集2013-2022年嘉兴市报告的≤24岁肺结核病例资料,包括人口学信息、诊疗信息和病原学检测结果等,描述性分析儿童青少年肺结核病例的发现延迟情况;采用多因素logistic回归模型分析肺结核发现延迟的影响因素。结果2013-2022年嘉兴市报告儿童青少年肺结核2407例,男性1522例,占63.23%。年龄M(QR)为21.00(4.00)岁。学生410例,占17.03%。外地户籍1856例,占77.11%。发现延迟596例,发现延迟率为24.76%;就诊延迟895例,就诊延迟率为37.18%;确诊延迟128例,确诊延迟率为5.32%。多因素logistic回归分析结果显示,一季度出现症状(OR=1.684,95%CI:1.261~2.249)、首诊单位级别为县级(OR=3.800,95%CI:2.898~4.983)和病原学检测阳性(OR=1.534,95%CI:1.255~1.874)是儿童青少年肺结核发现延迟的影响因素。结论2013-2022年嘉兴市儿童青少年肺结核发现延迟与症状出现时间、首诊单位级别和病原学检测结果有关,应加强肺结核防治宣传、扩大筛查项目覆盖范围和提升医疗机构诊疗能力。Objective To investigate the delay in identification of pulmonary tuberculosis and influencing factors among children and adolescents in Jiaxing City,Zhejiang Province from 2013 to 2022,so as to provide the reference for target-ed prevention and control measures.Methods The information of pulmonary tuberculosis patients in Jiaxing City from 2013 to 2022 were captured from the Tuberculosis Information Management System of Chinese Disease Control and Pre-vention Information System,including demographics,diagnosis,treatment and etiological results.The delay in identifica-tion of pulmonary tuberculosis was analyzed among children and adolescents,and the factors affecting the delay in iden-tification of pulmonary tuberculosis were identified using a multivariable logistic regression model.Results A total of 2407 pulmonary tuberculosis cases were reported among children and adolescents in Jiaxing City from 2013 to 2022,including 1522 males(63.23%).The median age was 21.00(interquartile range,4.00)years.There were 410 students(17.03%),and 1856 cases with non-local household registration(77.11%).There were 596 cases with delay in identifi-cation of tuberculosis(24.76%),895 cases with delay in healthcare-seeking(37.18%)and 128 cases with delay in defin-itive diagnosis(5.32%).Multivariable logistic regression analysis that children and adolescents who occurred symptoms in the first quarter(OR=1.684,95%CI:1.261-2.249),were diagnosed first in county-level medical institutions(OR=3.800,95%CI:2.898-4.983)and had positive results of etiological testing(OR=1.534,95%CI:1.255-1.874)were more likely to delay in identification of pulmonary tuberculosis.Conclusions The delay in identification of pulmonary tuber-culosis is associated with the time of symptom onset,the level of medical institution making first diagnosis,and the re-sults of etiological testing.It is suggested to reinforce the publicity of pulmonary tuberculosis prevention and control,ex-pand the coverage of screening programs and improve the diagnosis capability of medi

关 键 词：肺结核 儿童青少年 发现延迟 影响因素 

分 类 号：R521[医药卫生—内科学]