2015-2022年云南省重点地区结核病患者发现情况分析  

Analysis of tuberculosis case detection in key areas of Yunnan Province during 2015—2022

作　　者：卢昆云[1] 唐顺定 吴蔚 李玲[1] 杨蕊[1] 许琳[1] Lu Kunyun;Tang Shunding;Wu Wei;Li Ling;Yang Rui;Xu Lin(Tuberculosis Control Center,Yunnan Center for Disease Control and Prevention,Kunming 650500,China)

机构地区：[1]云南省疾病预防控制中心结核病防治所,昆明650500

出　　处：《结核与肺部疾病杂志》2024年第5期415-421,共7页Journal of Tuberculosis and Lung Disease

基　　金：云南省兴滇人才“名医人才专项”(YNWR-MY-2019-018);云南省高层次卫生计生技术人才培养项目(H-2019027)。

摘　　要：目的:分析比较《“十三五”全国结核病防治规划》实施以来,云南省重点地区与其他地区结核病患者发现情况,为制定结核病患者发现策略和措施提供参考依据。方法:收集云南省2015—2022年“中国疾病预防控制信息系统”中的肺结核患者报告信息、常规监测数据和登记治疗肺结核患者病案信息,对57个重点地区(27个国家级、30个省级乡村振兴重点帮扶县)、72个其他地区的结核病患者发现工作指标进行回顾性评价,分析比较结核病患者发现情况。结果:Joinpoint回归(Joinpoint regression,JPR)分析显示,2015—2022年云南省重点地区和其他地区肺结核报告发病率均呈“先上升后下降”的趋势,重点地区2015—2020年为明显上升期[年度变化百分比(annual percent change,APC)=4.18,P=0.028],2020—2022年为不明显下降期(APC=―6.28,P=0.247);其他地区2015—2017年为不明显上升期(APC=5.12,P=0.097),2017—2022年为明显下降期(APC=―6.24,P=0.001)。重点地区肺结核报告发病率为75.74/10万(123980/163689089),高于其他地区的45.31/10万(98587/217575588),差异有统计学意义(t=2.564,P=0.010)。重点地区的可疑者就诊人数占总人口的比例为4.72‰(788137/167080059),高于其他地区的3.86‰(825392/213889708),差异有统计学意义(χ^(2)=16380.378,P<0.001);就诊延迟发生率为68.84%(77857/113102),高于其他地区的57.58%(51287/89066),差异有统计学意义(χ^(2)=2735.422,P<0.001)。重点地区可疑者病原学检测率为72.99%(575241/788137),低于其他地区的78.11%(644706/825392),差异有统计学意义(χ^(2)=5734.282,P<0.001);病原学阳性率为41.78%(46673/111717),低于其他地区45.45%(38887/85552),差异有统计学意义(χ^(2)=266.613,P<0.001)。结论:《“十三五”全国结核病防治规划》实施以来,云南省重点地区和其他地区在肺结核患者发现方面明显提升;但重点地区的患者发现工作力度仍然不够,需要继续坚持主动筛�Objective:To analyze and compare the situation of tuberculosis(TB)case detection in key areas of Yunnan Province with other areas since the implementation of the 13th Five-Year Plan for National Tuberculosis Control and Prevention,and to provide a reference basis for the development of TB case-detection strategies and measures.Methods:The information of pulmonary TB patient notification,routine surveillance data and medical record information of TB patients registered for treatment in Yunnan Province from 2015 to 2022 were collected from the China Disease Control and Prevention Information System(CDCIS).The indicators on assessing TB case-detection work in 57 key districts/counties(27 national-level and 30 provincial-level counties for rural revitalization)and 72 other districts/counties were retrospectively evaluated,and the situation of TB case-detection were analyzed and compared.Results:Joinpoint regression(JPR)analysis showed that the reported incidence rates of TB in the key areas and other areas of Yunnan Province had a trend of“firstly rising and then declining”from 2015 to 2022.In the key areas,the rate was a significant increase from 2015 to 2020(annual percentage change,APC=4.18,P=0.028)and an insignificant decline from 2020 to 2022(APC=―6.28,P=0.247);in other areas,it was a period of insignificant increase(APC=5.12,P=0.097)from 2015 to 2017 and a period of significant decline(APC=―6.24,P=0.001)from 2017 to 2022.The reported incidence rate of pulmonary TB was 75.74 per 100000(123980/163689089)in the key areas,higher than that in other areas(45.31 per 100000,98587/217575588)with a statistically significant difference(t=2.564,P=0.010).The proportion of TB suspects who sought health care in the key areas was 4.72‰(788137/167080059)among the total population,higher than that in other areas(3.86‰,825392/213889708),the difference was statistically significant(χ^(2)=16380.378,P<0.001).The incidence of delayed health care seeking in the key areas was 68.84%(77857/113102),which was higher than 57.5

关 键 词：结核 卫生工作重点 传染病控制 云南省 

分 类 号：R183[医药卫生—流行病学]