Chinese Journal of Antituberculosis ›› 2021, Vol. 43 ›› Issue (5): 506-512.doi: 10.3969/j.issn.1000-6621.2021.05.017
• Original Articles • Previous Articles Next Articles
XIE Yan-tao*, GAO Han-qing, WU Yue, WANG Sai-sai, KANG Wan-li, LIU Yang()
Received:
2021-03-17
Online:
2021-05-10
Published:
2021-04-30
Contact:
LIU Yang
E-mail:lygyl1973@126.com
XIE Yan-tao, GAO Han-qing, WU Yue, WANG Sai-sai, KANG Wan-li, LIU Yang. Influencing factors of patient delay and diagnosis delay among tuberculosis patients in schools of Tongzhou District, Beijing,2014—2019[J]. Chinese Journal of Antituberculosis, 2021, 43(5): 506-512. doi: 10.3969/j.issn.1000-6621.2021.05.017
Add to citation manager EndNote|Ris|BibTeX
URL: http://www.zgflzz.cn/EN/10.3969/j.issn.1000-6621.2021.05.017
特征 | 患者 例数 | 就诊延误 | 诊断延误 | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
未延误 | 延误 | χ2值 | P值 | 未延误 | 延误 | χ2值 | P值 | ||||||||||
性别 | 1.228 | 0.268 | 1.751 | 0.186 | |||||||||||||
男 | 94 | 81(86.2) | 13(13.8) | 65(69.1) | 29(30.9) | ||||||||||||
女 | 58 | 46(79.3) | 12(20.7) | 34(58.6) | 24(41.4) | ||||||||||||
年龄(岁)a | - | 0.069 | - | 0.234 | |||||||||||||
0~6 | 5 | 5(100.0) | 0(0.0) | 2(40.0) | 3(60.0) | ||||||||||||
7~17 | 44 | 41(93.2) | 3(6.8) | 26(59.1) | 18(40.9) | ||||||||||||
≥18 | 103 | 81(78.6) | 22(21.4) | 71(68.9) | 32(31.1) | ||||||||||||
户籍 | 0.048 | 0.827 | 1.419 | 0.233 | |||||||||||||
北京 | 76 | 64(84.2) | 12(15.8) | 46(60.5) | 30(39.5) | ||||||||||||
非北京 | 76 | 63(82.9) | 13(17.1) | 53(69.7) | 23(30.3) | ||||||||||||
职业 | 2.669 | 0.102 | 1.471 | 0.225 | |||||||||||||
学生 | 124 | 107(86.3) | 17(13.7) | 78(62.9) | 46(37.1) | ||||||||||||
教职工 | 28 | 20(71.4) | 8(28.6) | 21(75.0) | 7(25.0) | ||||||||||||
学校性质 | 2.311 | 0.128 | 0.232 | 0.63 | |||||||||||||
公办 | 123 | 106(86.2) | 17(13.8) | 79(64.2) | 44(35.8) | ||||||||||||
民办 | 29 | 21(72.4) | 8(27.6) | 20(69.0) | 9(31.0) | ||||||||||||
校医配置情况 | 1.245 | 0.537 | 0.303 | 0.897 | |||||||||||||
无校医 | 37 | 29(78.4) | 8(21.6) | 23(62.2) | 14(37.8) | ||||||||||||
兼职校医 | 6 | 5(83.3) | 1(16.7) | 4(66.7) | 2(33.3) | ||||||||||||
专职校医 | 109 | 93(85.3) | 16(14.7) | 72(66.1) | 37(33.9) | ||||||||||||
特征 | 患者 例数 | 就诊延误 | 诊断延误 | ||||||||||||||
未延误 | 延误 | χ2值 | P值 | 未延误 | 延误 | χ2值 | P值 | ||||||||||
执行晨午检 | 8.356 | 0.004 | 4.155 | 0.042 | |||||||||||||
是 | 42 | 41(97.6) | 1(2.4) | 22(52.4) | 20(47.6) | ||||||||||||
否 | 110 | 86(78.2) | 24(21.8) | 77(70.0) | 33(30.0) | ||||||||||||
住宿情况 | 5.047 | 0.027 | 0.899 | 0.343 | |||||||||||||
住宿 | 91 | 71(78.0) | 20(22.0) | 62(68.1) | 29(31.9) | ||||||||||||
走读 | 61 | 56(91.8) | 5(8.2) | 37(60.7) | 24(39.3) | ||||||||||||
学校所在地性质 | 0.225 | 0.635 | 0.336 | 0.562 | |||||||||||||
城区 | 116 | 96(82.8) | 20(17.2) | 77(66.4) | 39(33.6) | ||||||||||||
乡镇 | 36 | 31(86.1) | 5(13.9) | 22(66.1) | 14(38.9) | ||||||||||||
学校级别a | - | 0.631 | - | 0.849 | |||||||||||||
高等教育机构 | 76 | 62(81.6) | 14(18.4) | 52(68.4) | 24(31.6) | ||||||||||||
中等教育机构 | 53 | 45(84.9) | 8(15.1) | 33(62.3) | 20(37.7) | ||||||||||||
小学 | 7 | 7(100.0) | 0(0.0) | 4(57.1) | 3(42.9) | ||||||||||||
托幼机构 | 16 | 13(81.3) | 3(18.7) | 10(62.5) | 6(37.5) | ||||||||||||
发病季度 | 9.006 | 0.025 | 10.703 | 0.013 | |||||||||||||
第一季度 | 38 | 31(81.6) | 7(18.4) | 21(55.3) | 17(44.7) | ||||||||||||
第二季度 | 58 | 54(93.1) | 4(6.9) | 46(79.3) | 12(20.7) | ||||||||||||
第三季度 | 24 | 20(83.3) | 4(16.7) | 11(45.8) | 13(54.2) | ||||||||||||
第四季度 | 32 | 22(68.7) | 10(31.3) | 21(65.6) | 11(34.4) | ||||||||||||
首诊医疗机构 | 0.379 | 0.772 | 12.908 | 0.000 | |||||||||||||
定点医疗机构 | 79 | 64(81.0) | 15(19.0) | 62(78.5) | 17(21.5) | ||||||||||||
非定点医疗机构 | 73 | 63(86.3) | 10(13.7) | 37(50.7) | 36(49.3) | ||||||||||||
发现途径 | 10.318 | 0.004 | 11.785 | 0.003 | |||||||||||||
被动发现b | 97 | 74(76.3) | 23(23.7) | 58(59.8) | 39(40.2) | ||||||||||||
健康体检 | 27 | 26(96.3) | 1(3.7) | 15(55.6) | 12(44.4) | ||||||||||||
密切接触者筛查 | 28 | 27(96.4) | 1(3.6) | 26(92.9) | 2(7.1) | ||||||||||||
咳嗽 | 6.889 | 0.009 | 0.752 | 0.386 | |||||||||||||
有 | 73 | 55(75.3) | 18(24.7) | 45(61.6) | 28(38.4) | ||||||||||||
无 | 79 | 72(91.1) | 7(8.9) | 54(68.4) | 25(31.6) | ||||||||||||
咯血 | 2.083 | 0.149 | 0.017 | 0.895 | |||||||||||||
有 | 15 | 15(100.0) | 0(0.0) | 10(66.7) | 5(33.3) | ||||||||||||
无 | 137 | 112(81.8) | 25(18.2) | 89(65.0) | 48(35.0) | ||||||||||||
发热 | 2.511 | 0.127 | 1.905 | 0.168 | |||||||||||||
有 | 36 | 27(75.0) | 9(25.0) | 20(55.6) | 16(44.4) | ||||||||||||
无 | 116 | 100(86.2) | 16(13.8) | 79(68.1) | 37(31.9) | ||||||||||||
诊断情况a | - | 1.000 | - | 0.115 | |||||||||||||
原发性肺结核 | 4 | 4(100.0) | 0(0.0) | 1(25.0) | 3(75.0) | ||||||||||||
继发性肺结核 | 133 | 110(82.7) | 23(17.3) | 86(64.7) | 47(35.3) | ||||||||||||
结核性胸膜炎 | 15 | 13(86.7) | 2(13.3) | 12(80.0) | 3(20.0) |
延误类型 | 自变量 | β值 | s | Wald χ2值 | P值 | OR(95%CI)值 |
---|---|---|---|---|---|---|
就诊延误 | 执行晨午检 | |||||
否:是 | 3.292 | 1.088 | 9.154 | 0.002 | 26.900(3.188~226.978) | |
发病季度 | ||||||
第一季度:第四季度 | -1.006 | 0.711 | 2.001 | 0.157 | 0.366(0.091~1.474) | |
第二季度:第四季度 | -2.414 | 0.753 | 10.286 | 0.001 | 0.089(0.020~0.391) | |
第三季度:第四季度 | -1.776 | 0.793 | 5.020 | 0.025 | 0.169(0.036~0.801) | |
发现途径 | ||||||
健康体检:被动发现a | -3.025 | 1.120 | 7.298 | 0.007 | 0.049(0.005~0.436) | |
密切接触者筛查:被动发现 | -2.430 | 1.127 | 4.649 | 0.031 | 0.088(0.010~0.802) | |
确诊延误 | 首诊医疗机构 | |||||
非定点医疗机构:定点医疗机构 | 0.970 | 0.401 | 5.861 | 0.015 | 2.638(1.203~5.785) | |
发现途径 | ||||||
健康体检:被动发现 | -0.206 | 0.471 | 0.191 | 0.662 | 0.814(0.324~2.048) | |
密切接触者筛查:被动发现 | -1.776 | 0.783 | 5.151 | 0.023 | 0.169(0.037~0.785) |
[1] | 秦田秀, 尹宁, 赵日秀. 1起学校聚集性结核病疫情分析. 中国校医, 2015,29(3):193-194. |
[2] | 陈文华, 张丹丹, 赵南, 等. 哈尔滨市两起学校肺结核病聚集性疫情对比分析. 中国公共卫生管理, 2015,31(1):67-73. doi: 10.19568/j.cnki.23-1318.2015.01.028. |
[3] | 王美花, 曹艳民, 王晓婷, 等. 济南市一起高中生肺结核聚集性疫情分析. 中国学校卫生, 2016,37(8):1223-1225. doi: 10.16835/j.cnki.1000-9817.2016.08.033. |
[4] | 孟炜丽, 王芳华, 王春梅, 等. 5起学校结核病聚集性疫情分析. 中国热带医学, 2018,18(2):176-177. doi: 10.13604/j.cnki.46-1064/r.2018.02.20. |
[5] | 中华人民共和国卫生部结核病控制项目办公室. 世界银行贷款中国结核病控制项目工作手册.2版. 北京: 中华人民共和国卫生部结核病控制项目办公室, 1995: 22-23. |
[6] | 龚幼龙, 万利亚, 武桂英, 等. 结核病控制经济与管理学评价, 上海: 第二军医大学出版社, 2003: 87. |
[7] |
Screeramareddy CT, Qin ZZ, Satyanarayana S, et al. Delays in diagnosis and treatment of pulmonary tuberculosis in India: a systematic review. Int J Tuberc Lung Dis, 2014,18(3):255-266. doi: 10.5588/ijtld.13.0585.
doi: 10.5588/ijtld.13.0585 URL pmid: 24670558 |
[8] |
Getnet F, Demissie M, Assefa N, et al. Delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: systematic review and meta-analysis. BMC Pulm Med, 2017,17(1):202. doi: 10.1186/s12890-017-0551-y.
doi: 10.1186/s12890-017-0551-y URL pmid: 29237451 |
[9] | 白丽琼, 肖水源. 湖南省农村传染性肺结核患者发现延误的影响因素研究. 中华结核和呼吸杂志, 2004,27(9):617-620. doi: 10.3760/j:issn:1001-0939.2004.09.011. |
[10] |
陈松华, 王晓萌, 钟节鸣, 等. 肺结核病新患者发现延误及影响因素分析. 中国公共卫生, 2013,29(4):481-484. doi: 10.11847/zgggws2013-29-04-05.
doi: 10.11847/zgggws2013-29-04-04 URL |
[11] | 刘建雄, 杜雨华, 沈鸿程, 等. 2008—2018年广州市结核病患者诊断延误影响因素分析. 中国防痨杂志, 2021,43(1):81-86. doi: 10.3969/j.issn.1000-6621.01.015. |
[12] | 邓海巨, 郑亦慧, 张宇艳, 等. 上海市普陀区非户籍人口结核病诊断延误及其影响因素研究. 中华流行病学杂志, 2006,27(4):311-315. doi: 10.3760/j.issn:0254-6450.2006.04.008. |
[13] | 梁志强, 雷宇, 杜雨华, 等. 广州市越秀区442例学生肺结核患者诊断延误情况分析. 现代医院, 2018,18(7):996-998. doi: 10.3969/j.issn.1671-332X.2018.07.020. |
[14] | 王倪. 新发涂阳肺结核患者延误水平与影响因素的研究. 北京: 中国疾病预防控制中心, 2011. |
[15] | 孟炜丽, 陈曦. 北京市西城区899例活动性肺结核患者流行特征及诊断延误情况分析. 中国防痨杂志, 2013,35(5):395-397. |
[16] | 徐松艳, 刘爱萍. 北京市朝阳区肺结核患者就诊及确诊延误情况调查分析. 慢性病学杂志, 2013,14(10):765-769. doi: 10.16440/j.cnki.1674-8166.2013.10.013. |
[17] | 屠德华, 万利亚, 王黎霞, 等. 现代结核病控制理论与实践. 北京: 军事医学科学出版社, 2009: 198-199. |
[18] | 苏莉, 孙玉梅, 林可可, 等. 肺结核就诊和确诊延误原因的质性研究. 中国全科医学, 2013,16(2A):406-408. doi: 10.3969/j.issn.1007-9572.2013.02.017. |
[19] | 姜世闻, 成君, 李雪, 等. 肺结核患者发现方式的进展和建议. 中国防痨杂志, 2015,37(10):1012-1019. doi: 10.3969/j.issn.1000-6621.2015.10.003. |
[20] | 杨妮, 饶正远, 夏岚, 等. 2016—2018年四川省学生活动性肺结核患者发现延迟影响因素分析. 疾病监测, 2019,34(12):1113-1116. doi: 10.3784/j.issn.1003-9961.2019.12.017. |
[21] | 陈彬, 王晓萌, 顾华, 等. 浙江省学生肺结核患者发现延误影响因素分析. 中国学校卫生, 2013,34(11):1339-1341. doi: 10.16835/j.cnki.1000-9817.2013.11.022. |
[22] | 郭培军, 周正全, 王淑蕾, 等. 2011—2015年烟台市学生肺结核患者就诊延误影响因素分析. 中国病原生物学杂志, 2016,11(12):1074-1078. doi: 10.13350/j.cjpb.161205. |
[23] | 杨俊超, 杜亚平. 肺结核发现延误的影响因素及对策. 浙江预防医学, 2011,23(8):22-24. doi: 10.19485/j.cnki.issn1007-0931.2011.08.007. |
[1] | National Clinical Research Centre for Infectious Disease/The Third People’s Hospital of Shenzhen, Peking University Shenzhen Hospital, Peking Union Medical College Hospital of Chinese Academy of Medical Sciences, Chinese Antituberculosis Association, Editorial Board of Chinese Journal of Antituberculosis, Shenzhen Key Laboratory of Inflammatory and Immune Diseases. Expert consensus on diagnosis and treatment of latent tuberculosis infection in patients with rheumatic diseases [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 869-879. |
[2] | Ultrasound Professional Committee of Tuberculosis Branch of Chinese Medical Association, Interventional Ultrasound Professional Committee of Interventional Physician Branch of Chinese Medical Doctor Association Danwei. Expert consensus on ultrasound diagnosis, classification and interventional therapy of tuberculous pleurisy (2022 Edition) [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 880-897. |
[3] | Bao Rong, Gao Jianfeng, Rao Yan. Pathological types and characteristics of experimental pulmonary tuberculosis [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 898-905. |
[4] | Wang Yuxiang, Chen Qiuqi, Yu Xinxin, Zhan Senlin, Zhang Peize, Deng Guofang. 3HP regimen in the treatment of rheumatic diseases complicated with Mycobacterium tuberculosis latent infection:a prospective study [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 906-910. |
[5] | Xie Jingyi, Zou Ruifeng, Chen Yulan, Chen Yong, Liu Dongzhou, Hong Xiaoping. Analysis of clinical features and peripheral lymphocyte subsets of systemic lupus erythematosus patients complicated with tuberculosis infection [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 911-916. |
[6] | Cheng Xiao, Chen Zhe, Jiao Xuefeng, Yang Nan, Diao Sha, Ni Xiaofeng, Liu Zheng, He Siyi, Zeng Linan, Wan Chaomin, Kang Deying, Wu Bin, Ying Binwu, Zhang Hui, Zhao Rongsheng, Zhang Lingli. Efficacy and safety of recombinant Mycobacterium tuberculosis fusion proteins (EC) for the diagnosis of Mycobacterium tuberculosis infection: A system review [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 917-926. |
[7] | Wang Ni, Huang Fei, Zhu Limei, Zeng Yi, Zhang Ruimei, Geng Hong, Liu Xuefa, Zheng Jiangang, Zong Peilan, Zeng Zhong, Li Jinlan, Cai Cui, Guo Xiaohong, Zhong Yin, Liu Li, Xie Yan, Du Fangfang, Zhou Lin, Cheng Shiming. Implementation study on promoting the use of anti-tuberculosis fixed-dose combination in provincial and prefecture tuberculosis designated hospitals [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 927-933. |
[8] | Wei Ganhui, Zhang Jiacheng, Qiu Xiaowei. Application value of volume CT value inquantifying the activity of pulmonary tuberculosis lesions above 5 mm [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 934-939. |
[9] | Wang Chaohong, Sun Qing, Liao Xinlei, Yan Jun, Wang Chenqian, Jiang Guanglu, Wang Fen, Xue Yi, Huang Hairong, Wang Guirong. Analysis of drug resistance situation of Mycobacterium tuberculosis strains from 231 spinal tuberculosis patients [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 940-946. |
[10] | Nie Tingyue, Chen Wei, Zhang Jieying, Cao Hong, Qian Bing, Gu Yingqiang, Liu Xuxiang. Analysis of spatial distribution characteristics of pulmonary tuberculosis cases in Hefei City, 2009—2020 [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 947-953. |
[11] | Wu Wenqi, Zhong Jianqiu, He Juan, Deng Guofang, Wang Qingwen. The research progress of the reactivation of latent tuberculosis infection in patients with rheumatic diseases [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 954-959. |
[12] | Chen Qiuqi, Han Tingting, Wang Qingwen, Deng Guofang. Recent advances in treatment of latent tuberculosis infection complicated with rheumatic diseases [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 960-965. |
[13] | Han Xu, Guan Shangqi, Shi Yinpeng, Mei Yifang. The risk of tuberculosis infection with non-tumor necrosis factor-targeted drugs in the treatment of rheumatoid arthritis [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 966-972. |
[14] | Yao Rong, Lu Yu. Research progress on the drug resistance and mechanism of the anti-tuberculosis drug bedaquiline [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 973-977. |
[15] | Xie Fanghui, Liang Li, Zhao Xia, Yao Rong, Lei Limei, Guo Hui, Meng Meng, Wan Bin. Research progress of sputum specimen collection in patients with pulmonary tuberculosis [J]. Chinese Journal of Antituberculosis, 2022, 44(9): 978-982. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||