关键词: 结核, 分子生物学, 核酸探针, 小地区分析

Abstract:

Objective To analyze the application of nucleic acid detection technology for tuberculosis(TB) molecular biology in the project of “Explore and improve the level of tuberculosis detection in poor areas” implemented in Linfen, Shanxi from 2019 to 2020, to provide evidence for optimizing the strategy of TB prevention and control in Linfen. Methods Data of China’s Disease Prevention and Control Information System and its subsystem TB Management Information System, and the monthly report of the “Explore and improve the level of tuberculosis detection in poor areas” project were collected. Data of 2018 were selected as baseline, active pulmonary TB patients, detection of TB patients and drug sensitivity screening in Linfen from 2019 to 2020 were analyzed. Results The positive rates of etiology in Linfen increased year by year and were 29.6% (442/1495), 36.4% (476/1307) and 50.5% (652/1292), respectively, from 2018 to 2020, the difference was statistically significant ($χ{^{2}_{trend}}$=152.410, P=0.000). By 2020, in 17 counties and districts, 50% of the active pulmonary TB patients and pulmonary TB patients with positive etiology in Fushan, Hongdong, Anze and Yicheng counties (76.2% (32/42), 64.7% (174/269), 60.0% (9/15), 55.9% (38/68), respectively; and 76.5% (13/17), 70.4% (81/115), 7/7, 66.7% (24/36), respectively) were diagnosed by municipal hospital (Linfen Third People’s Hospital), while the rates in Daning and Yonghe were not (69.4% (25/36), 81.8% (18/22) and 59.3% (16/27), 66.7% (8/12)). From 2018 to 2020, the drug sensitivity screening rates in Linfen were yearly increased (75.1% (229/(442-137), 88.5% (339/(476-93) and 90.7% (489/(652-113), respectively), the difference was statistically significant ($χ{^{2}_{trend}}$=25.505, P=0.000). From 2018 to 2020, the positive rates of etiology in Daning and Yonghe were 31.2% (15/48), 25.0% (14/56) and 54.0% (34/63), respectively, with significant difference (χ ²=170.407, P=0.000); the proportion of newly diagnosed patients in Daning and Yonghe by municipal hospital increased from 38.4% (106/276) to 43.4% (75/173) and 56.3% (98/174) ($χ{^{2}_{trend}}$=36.564, P=0.000). Conclusion Linfen Third People’s Hospital provides Linfen a full range of TB molecular biological test. The diagnosis and treatment process should continue optimized to achieve the goal of graded diagnosis and treatment of common TB patients in the county, and the municipal diagnosis could work as a regional molecular biological diagnostic laboratory for TB.

Key words: Tuberculosis, Molecular biology, Nucleic acid probes, Small-area analysis