金华市学生结核病病例发现延迟的影响因素分析  

Influencing factors for delay in identification of tuberculosis among students in Jinhua City

作　　者：陈高尚[1] 朱凯强 朱军礼[1] 李克 CHEN Gaoshang;ZHU Kaiqiang;ZHU Junli;LI Ke(Jinhua Center for Disease Control and Prevention,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市疾病预防控制中心,浙江金华321000

出　　处：《预防医学》2024年第8期698-701,共4页China Preventive Medicine Journal

基　　金：金华市公益性技术应用研究项目(2022-4-226)。

摘　　要：目的分析浙江省金华市学生结核病病例发现延迟的影响因素,为加强学校结核病防控工作提供参考。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2012—2023年金华市学生结核病病例资料,包括人口学信息、诊疗信息和病原学检测结果等,描述性分析学生肺结核病例发现延迟率。采用多因素logistic回归模型分析发现延迟的影响因素。结果2012—2023年金华市累计报告学生结核病病例1592例,发现延迟601例,发现延迟率为37.75%;其中,男生和女生发现延迟率分别为36.11%和39.70%;小学生、初中生、高中生和大学生发现延迟率分别为48.68%、44.97%、31.44%和42.49%。多因素logistic回归分析结果显示,学段(高中,OR=0.576,95%CI:0.350~0.947)、首发症状出现时间(二季度,OR=0.620,95%CI:0.466~0.826;四季度,OR=0.681,95%CI:0.498~0.930)、发现途径(推介,OR=12.221,95%CI:3.525~42.366;直接就诊,OR=9.409,95%CI:4.234~20.908;转诊,OR=3.642,95%CI:1.970~6.733;追踪,OR=6.372,95%CI:3.362~12.077)、诊断结果(病原学阴性,OR=0.499,95%CI:0.399~0.624)和诊断机构(市级定点医院,OR=0.731,95%CI:0.541~0.988)是学生结核病病例发现延迟的影响因素。结论金华市学生结核病病例发现延迟主要与病例发现途径、诊断结果、诊断机构等因素有关。Objective To analyze the influencing factors of delay in identification of pulmonary tuberculosis among students in Jinhua City,Zhejiang Province from 2012 to 2023,so as to provide the reference for strengthening prevention and control of tuberculosis in schools.Methods Data of tuberculosis cases among students in Jinhua City were collected through the Tuberculosis Information Management System of the Chinese Disease Prevention and Control Information System from 2012 to 2023,including demographic information,diagnosis and treatment information,and pathogen detection results.The prevalence of delay in identification of tuberculosis among students was described,and its influencing factors were analyzed using a multivariable logistic regression model.Results A total of 1592 tuberculosis cases among students were reported in Jinhua City from 2012 to 2023,with 601 cases(37.75%)founded delay in identification.The prevalence rates of delay in identification of tuberculosis among male and female students were 36.11%and 39.70%,respectively.The prevalence rates of delay in identification of tuberculosis among primary school,junior high school,high school and college students were 48.68%,44.97%,31.44%and 42.49%,respectively.Multivariable logistic regression analysis identified educational level(high school,OR=0.576,95%CI:0.350-0.947),onset time of first symptoms(second quarter,OR=0.620,95%CI:0.466-0.826;fourth quarter,OR=0.681,95%CI:0.498-0.930),detection routes(referral,OR=12.221,95%CI:3.525-42.366;direct consultation,OR=9.409,95%CI:4.234-20.908;transfer,OR=3.642,95%CI:1.970-6.733;follow-up,OR=6.372,95%CI:3.362-12.077),etiological test results(negative,OR=0.499,95%CI:0.399-0.624),and diagnostic institutions(municipal designated hospitals,OR=0.731,95%CI:0.541-0.988)as factors affecting the delay in identification of tuberculosis among students.Conclusion The delay in identification of tuberculosis among students in Jinhua City is primarily associated with the routes of case detection,etiological test results and diagnostic

关 键 词：结核病 学生 发现延迟 影响因素 

分 类 号：R521[医药卫生—内科学]