A survey on TB screening among four high-risk groups in general medical institutions in Tianjin City

doi:10.19982/j.issn.1000-6621.20220018

Abstract

Abstract:

Objective: To investigate the current status of tuberculosis screening in inpatients with unilateral pleural effusion, hemoptysis and inpatients prescribed with immunosuppressant or long-term glucocorticoid in general medical institutions of Tianjin City. Methods: Convenient sampling was used to select 31 general medical institutions with large number of TB cases in Tianjin City as study sites, then 10 inpatients’ medical records were selected from designated department of each medical institution, a total of 1240 patients were included and finally records of 419 patients meeting definition of the 4 high-risk groups were extracted as research objects, including 164, 97, 86 and 72 patients for each of the unilateral pleural effusion group, hemoptysis group, immunosuppressant group and long-term glucocorticoid group. Results: The 31 general medical institutions were mainly tertiary hospitals, accounting for 80.6% (25/31).46.1% (193/419) of the 4 high-risk groups completed examination for TB diagnosis. 57.3% (94/164), 52.6% (51/97), 29.1% (25/86), 31.9% (23/72) of inpatients completed the examination for each of the unilateral pleural effusion group, hemoptysis group, immunosuppressant group and long-term glucocorticoid group.The proportions of patients taking smear, culture, GeneXpert, TST, IGRA and tuberculosis antibody examination were 64.8% (125/193), 16.6% (32/193), 10.9% (21/193), 8.3% (16/193), 18.1% (35/193) and 34.2% (66/193), respectively. The proportion of IGRA examination was 21.1% (35/66) in tertiary general medical institutions, higher than 0.0% (0/27) in secondary general medical institutions with statistically significant difference (χ²=6.954, P=0.005), while the proportion of tuberculosis antibody examination was 31.3% (52/166) in tertiary institutions, lower than that of secondary institutions(51.9%, 14/27), the difference was statistically significant (χ ²=4.348, P=0.049) too. Conclusion: In Tianjin City, the proportion of high-risk population undergoing tuberculosis examinations in general medical institutions was quite low which should be further improved.

Key words: Tuberculosis, Pleural effusion, Haemoptysis, Immunosuppressant, Glucocorticoids, Hospital,general, Tianjin city

CLC Number:

GAO Li, PANG Xue-wen, WAN Ying, YANG Guang-wei, LI Dan, ZHANG Wen-qian, CHEN Sheng-yu. A survey on TB screening among four high-risk groups in general medical institutions in Tianjin City[J]. Chinese Journal of Antituberculosis, 2022, 44(4): 397-402. doi: 10.19982/j.issn.1000-6621.20220018

Figures/Tables 3

References 29

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高危人群类型	三级综合医疗机构		二级综合医疗机构		合计
高危人群类型	患者例数	完成结核确诊相关检查[例, 比例(%)]	患者例数	完成结核确诊相关检查[例, 比例(%)]	患者例数	完成结核确诊相关检查[例, 比例(%)]
单侧胸腔积液住院患者	128	75(58.6)	36	19(52.8)	164	94(57.3)
咯血住院患者	89	47(52.8)	8	4(50.0)	97	51(52.6)
拟应用免疫抑制剂住院患者	85	25(29.4)	1	0(0.0)	86	25(29.1)
拟长期应用糖皮质激素住院患者	65	19(29.2)	7	4(57.1)	72	23(31.9)
合计	367	166(45.2)	52	27(51.9)	419	193(46.1)

高危人群类型	患者例数	病原学检查 [例,比例(%)]			免疫学检查[例,比例(%)]
高危人群类型	患者例数	涂片	培养	GeneXpert MTB/RIF	TST	IGRA	结核抗体
单侧胸腔积液住院患者	94	62(66.0)	15(16.0)	12(12.8)	5(5.3)	7(7.4)	48(51.1)
咯血住院患者	51	44(86.3)	11(21.6)	7(13.7)	0(0.0)	0(0.0)	0(0.0)
拟应用免疫抑制剂住院患者	25	11(44.0)	4(16.0)	0(0.0)	8(32.0)	16(64.0)	9(36.0)
拟长期应用糖皮质激素住院患者	23	8(34.8)	2(8.7)	2(8.7)	3(13.0)	12(52.2)	9(39.1)
χ²值		0.354	0.101	0.143	0.316	0.564	0.130
P值		0.000	0.576	0.268	0.001	0.000	0.302

医疗机构级别	患者例数	病原学检查 [例,比例(%)]			免疫学检查[例,比例(%)]
医疗机构级别	患者例数	涂片	培养	GeneXpert MTB/RIF	TST	IGRA	结核抗体
三级	166	104(62.7)	25(15.1)	20(12.0)	15(9.0)	35(21.1)	52(31.3)
二级	27	21(77.8)	7(25.9)	1(3.7)	1(3.7)	0(0.0)	14(51.9)
χ²值		2.329	1.982	1.688	1.008	6.954	4.348
P值		0.191	0.168	0.319	0.474	0.005	0.049