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中国防痨杂志 ›› 2024, Vol. 46 ›› Issue (2): 183-189.doi: 10.19982/j.issn.1000-6621.20230303

• 论著 • 上一篇    下一篇

2015—2021年重庆市肺结核患者发现延误及影响因素分析

陈健1,2, 石林2, 雷蓉蓉2, 余雅2(), 汪清雅2, 吴成果2, 刘小秋3()   

  1. 1中国疾病预防控制中心中国现场流行病学培训项目, 北京 100050
    2重庆市结核病防治所防治科, 重庆 400050
    3中国疾病预防控制中心结核病预防控制中心, 北京 102206
  • 收稿日期:2023-08-21 出版日期:2024-02-10 发布日期:2024-01-30
  • 通信作者: 余雅,刘小秋 E-mail:yuya324@126.com;liuxq@chinacdc.cn
  • 基金资助:
    中国现场流行病学培训项目(131031001000200011);重庆市科卫联合医学科研项目(2023MSXM143);中美疾控中心合作项目

Analysis of delayed detection and the related influencing factors of pulmonary tuberculosis patients in Chongqing from 2015 to 2021

Chen Jian1,2, Shi Lin2, Lei Rongrong2, Yu Ya2(), Wang Qingya2, Wu Chengguo2, Liu Xiaoqiu3()   

  1. 1Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
    2Department of Control and Prevention, Chongqing Municipal Institute of Tuberculosis, Chongqing 400050, China
    3National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
  • Received:2023-08-21 Online:2024-02-10 Published:2024-01-30
  • Contact: Yu Ya,Liu Xiaoqiu E-mail:yuya324@126.com;liuxq@chinacdc.cn
  • Supported by:
    Chinese Field Epidemiology Training Program(131031001000200011);Chongqing Science and Health Joint Medical Research Project(2023MSXM143);China CDC-U.S.CDC Collaboration Program

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摘要： 目的: 分析2015—2021年重庆市肺结核患者发现延误情况及影响因素,为减少患者发现延误提供科学依据。方法: 从“中国疾病预防控制信息系统”子系统“传染病报告信息管理系统”收集2015—2021年重庆市肺结核患者相关信息,包括报告时间、患者的人口学特征(性别、年龄、职业)、地区、患者来源、疾病诊断、发病日期和诊断日期,共获得174067例患者信息。2015—2021年肺结核患者发现延误率的变化采用Joinpoint回归模型进行趋势分析,采用多因素logistic回归分析发现延误的影响因素。结果: 2015—2021年重庆市肺结核患者发现延误时间中位数为31(10,73)d,年均发现延误率为53.25%(92695/174067);由2015年的58.20%(15093/25935),下降至2021年的50.18%(11026/21974)。2015—2021年发现延误率总体呈下降趋势(AAPC=-2.5%,t=-2.095, P=0.036),2015—2019年发现延误率下降趋势差异有统计学意义(APC=-4.1%,t=-4.313, P=0.049),2019—2021年发现延误率变化差异无统计学意义(APC=0.8%,t=0.248, P=0.827)。多因素logistic回归分析显示,女性(OR=1.036,95%CI:1.015~1.059)、45~64岁年龄组(OR=1.095,95%CI:1.065~1.125)、无业(离退)人群(OR=1.233,95%CI:1.177~1.294)、农(牧、渔)民(工)(OR=1.624,95%CI:1.546~1.710)、学龄前儿童(OR=3.581,95%CI:2.271~5.761)、工人(OR=1.134,95%CI:1.062~1.213)、渝东北地区(OR=1.270,95%CI:1.244~1.312)、重庆市外(OR=1.136,95%CI:1.087~1.187)、病原学阳性(OR=1.033,95%CI:1.013~1.055)是肺结核患者出现发现延误的危险因素。结论: 重庆市肺结核患者的发现延误现象较为严重,随时间变化总体呈下降趋势。需要重点关注重点地区和重点人群发现延误情况,并采取综合性措施。

关键词: 结核,肺, 因素分析, 重庆市

Abstract: Objective: To analyze the delayed detection of pulmonary tuberculosis (PTB) patients in Chongqing from 2015 to 2021 and the influencing factors, to provide scientific basis for reducing detection delay of PTB. Methods: Relevant informations of 174067 pulmonary tuberculosis patients in Chongqing from 2015 to 2021 were collected from the subsystem “Infectious Disease Reporting Information Management System” of the China Information System for Disease Control and Prevention, including report time, demographic characteristics (gender, age, occupation), region, origin, diagnosis, date of onset, and date of diagnosis. The Joinpoint regression model was used to describe the change of detection delay rate from 2015 to 2021, the influencing factors of the detection delay were analyzed using logistic regression model. Results: From 2015 to 2021, the median and quartile of detection delay were 31 (10,73) d, with the average annual delay rate of 53.25% (92695/174067); the detection delay rate decreased from 58.20% (15093/25935) in 2015 to 50.18% (11026/21974) in 2021. From 2015 to 2021, detection delay rate showed a decreasing trend (AAPC=-2.5%, t=-2.095, P=0.036); from 2015 to 2019, a statistically significant decrease in delay rate was observed (APC=-4.1%, t=-4.313, P=0.049); while from 2019 to 2021, no statistically significant change in delay rate was found (APC=0.8%, t=0.248, P=0.827). The results of multivariate analysis showed that female (OR=1.036, 95%CI: 1.015-1.059), aged 45-64 years (OR=1.095, 95%CI: 1.065-1.125), unemployed or retired (OR=1.233, 95%CI: 1.177-1.294), farmers or herdsmen or fishermen or migrant worker (OR=1.624, 95%CI: 1.546-1.710), preschool (OR=3.581, 95%CI: 2.271-5.761), workers (OR=1.134, 95%CI: 1.062-1.213), lived in northeast region of Chongqing (OR=1.270, 95%CI: 1.244-1.312), being outside the urban area of Chongqing (OR=1.136, 95%CI: 1.087-1.187), and pathogenic positivity (OR=1.033, 95%CI: 1.013-1.055) were common risk factors for detection delay of PTB. Conclusion: The rate of detection delay of PTB in Chongqing is relatively serious, but the overall trend was decreasing with the time. More attention and comprehensive measures should be paid to key areas and populations.

Key words: Tuberculosis, pulmonary, Factor analysis, Chongqing

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