关键词: 结核,肺, 老年人, 病例发现, 登记, 发病率, 结果评价(卫生保健), 小地区分析

Abstract:

Objective To investigate the finding characteristics of pulmonary tuberculosis (PTB) in the elderly population in Xinjiang Uygur Autonomous Region (“Xinjiang”) from 2009 to 2017, in order to provide a scientific basis for the prevention and control management. Methods Clinical data, including the number of registered patients, age, gender, occupation, pathogen detection results (positive, negative and absent), how to find the patients, and the delayed diagnosis, etc., of PTB patients who aged ≥60 years and lived in Xinjiang, and registered from January 1, 2009 to December 31, 2017 were oained through Tuberculosis Information Management System, a subsystem of China Disease Prevention and Control Information System; and demographic data in each year from Xinjiang Annual Statistic were also collected. These data were analyzed using SPSS 25.0. P<0.05 was considered statistically significant. Results From 2009 to 2017, a total of 268765 PTB patients in Xinjiang were registered, of which 117125 were elderly (43.58% (117125/268765)), the proportion of PTB was increased from 36.94% (8753/23692) in 2009 to 50.17% (19810/39486) in 2017 (χ²_趋势=2257.798, P=0.000); and the rate of registered elderly patients was increased from 431.96/100000 (8753/2026328) in 2009 to 795.80/10⁵ (19810/2489318) in 2017 (χ²_趋势=4740.593, P=0.000). Of the 117125 elderly cases, etiology test was negative in 86013 (73.44%), the proportion was increased from 50.14% (4389/8753) in 2009 to 83.01% (16444/19810) in 2017 (χ²_趋势=6713.849, P=0.000). Mainly of the elderly PTB patients were male (54.98% (64400/117125)). The registered rate was lowest in patients aged 60-<65 years old (501.32/100000, 33365/6655379), and highest in patients aged 65-<70 years old (628.48/100000, 34315/5460043). The way of was mainly based on referral, seeing a doctor and recommendation were the main ways to find elderly PTB patients (75.50%,88433/117125). The delayed rate of PTB diagnosis in elderly patients in Xinjiang was 77.42% (90675/117125), while that of all aged cases was 52.89% (142150268765)). Conclusion The prevention and control situation of the elderly PTB in Xinjiang was serious, the registered incidence in aged was higher than that in all population. The case number, registered incidence and negative etiology patients increased year by year. Patients were mainly males, and found by referral, seeing a doctor or recommendation. The delayed rate of PTB diagnosis was high. Early prevention and control for elderly PTB should be managed.

Key words: Tuberculosis,pulmonary, Aged, Case finding outcomes, Registries, Incidence, Outcome assessment (health care), Small-area analysis