关键词: 结核, 高危人群, 监测, 医院,公立, 天津市

Abstract:

Objective: To understand the status of tuberculosis surveillance ability in four high-risk groups (patients with unilateral pleural effusion, hemoptysis, long-term use of systemic glucocorticoids and immunosuppressants) in public hospitals of Tianjin City. Methods: All secondary and above public general hospitals in Tianjin City and specialized hospitals with respiratory departments, infection departments and/or immune-related departments (hereinafter referred to as “monitoring institutions”) were included, and their settings of key departments (internal medicine, respiratory department, infection department, immune-related departments), tuberculosis (TB) examination methods and medical staff’s attitude towards monitoring tuberculosis were obtained by on-site questionnaire survey. Results: A total of 72 monitoring institutions were included, including 10 TB designated hospitals and 62 non-TB designated hospitals. (1) Setting of key departments: the proportions of having internal medicine, respiratory, infectious disease and rheumatology department were 97.22% (70/72), 62.50% (45/72), 59.72% (43/72) and 37.50% (27/72) respectively. (2) Tuberculosis examination methods: 10 TB designated hospitals had all required means of TB examination. All 62 non-TB designated hospitals had the capability of chest imaging examination, 72.58% (45/62) had at least one etiological examination and/or immunological examination, and most of them were tertiary hospitals. (3) Awareness rate of TB core knowledge: 181 public health staff and doctors from key clinical departments completed the questionnaire. The awareness rates for TB etiology, typical symptoms, main transmission routes and curability were 90.61% (164/181), 71.82% (130/181), 44.20% (80/181) and 97.24% (176/181), respectively. (4) Awareness rate of knowledge and attitude towards conducting TB surveillance among high-risk groups: 90 clinicians in key departments completed the questionnaire. Awareness rates of four high-risk population types, etiological examination methods, immunological examination methods, latent infection and preventive treatment were 96.67% (87/90), 86.67% (78/90), 93.33% (84/90), 60.00% (54/90) and 56.67% (51/90), respectively. 81.11% (73/90) of doctors considered it necessary to carry out TB surveillance in four high-risk groups. Conclusion: The capacity of etiological and immunological examination in non-TB designated hospitals, especially in secondary hospitals, is still insufficient. Typical symptoms and main transmission routes of TB are not fully mastered by medical staff, and the awareness rates of latent infection and preventive treatment are low, attitude towards conducting TB surveillance in high-risk groups is relatively positive.

Key words: Tuberculosis, High-risk groups, Monitor, Hospitals, public, Tianjin