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中国防痨杂志 ›› 2025, Vol. 47 ›› Issue (9): 1140-1147.doi: 10.19982/j.issn.1000-6621.20250203

• 论著 • 上一篇    下一篇

2024年浙江省主动与被动发现肺结核患者流行病学特征的对比研究

杨珂, 张钰, 王伟, 吴倩, 陈彬, 陈松华()   

  1. 浙江省疾病预防控制中心结核病预防控制所,杭州 310051
  • 收稿日期:2025-05-16 出版日期:2025-09-10 发布日期:2025-08-27
  • 通信作者: 陈松华 E-mail:shchen@cdc.zj.cn
  • 基金资助:
    国家重点研发计划(2024YFC2311202);浙江省医药卫生科技计划项目(2024KY902);浙江省医药卫生科技计划项目(2024KY886)

A comparative study on the epidemiological characteristics of actively and passively detected tuberculosis patients in Zhejiang Province, 2024

Yang Ke, Zhang Yu, Wang Wei, Wu Qian, Chen Bin, Chen Songhua()   

  1. Institute of Tuberculosis Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
  • Received:2025-05-16 Online:2025-09-10 Published:2025-08-27
  • Contact: Chen Songhua E-mail:shchen@cdc.zj.cn
  • Supported by:
    National Key Research and Development Program of China(2024YFC2311202);Zhejiang Provincial Medical and Health Project(2024KY902);Zhejiang Provincial Medical and Health Project(2024KY886)

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摘要：

目的: 通过对比主动和被动发现肺结核患者的流行病学特征,了解主动发现对肺结核防控工作的贡献和效果,为制定和优化今后的肺结核主动发现策略提供参考依据。方法: 采用回顾性队列研究,通过“中国疾病预防控制信息系统”的子系统“结核病信息管理系统”收集2024年浙江省肺结核患者个案基本信息,应用ANOVA F、Kruskal-Wallis H、χ2检验等统计学方法,分析比较浙江省主动和被动发现肺结核患者在人群分布、时间分布、空间分布、疾病特征、就诊时间等方面的差异。结果: 2024年浙江省登记肺结核患者21764例,其中,主动发现患者4977例(22.87%),被动发现患者16787例(77.13%)。主动发现比例在学生/儿童(43.55%)、≤14岁年龄段(44.75%)、≥65岁老年人群(20.38%);绍兴市(29.73%)、宁波市(28.26%)、嘉兴市(25.94%)、衢州市(23.44%)等地区;第二季度(24.15%)和第三季度(25.76%)等方面比较高。主动发现的患者就诊时间中位数(四分位数)为11.00(3.00~29.00)d,显著短于被动发现方式[19.00(7.00~40.00)d]。结论: 主动发现在早发现患者、缩短患者就诊延误、避免病情加重等方面较为有效,建议因地制宜分析研判区域肺结核疫情流行病学特征,优化公共卫生资源配置,针对疫情重点区域和重点人群强化主动发现。

关键词: 结核,肺, 主动发现, 被动发现, 流行病学特征(主题), 浙江省

Abstract:

Objective: To compare the epidemiological characteristics of pulmonary tuberculosis (PTB) patients detected through active versus passive case-finding in Zhejiang Province, China, during 2024, and to quantify the contribution of active detection to TB control. Methods: A retrospective cohort study was conducted using individual records from the China Disease Prevention and Control Information System in 2024. Demographic, temporal, spatial and clinical characteristics, as well as care-seeking interval, were compared between actively and passively detected cases with χ2, one-way ANOVA and Kruskal-Wallis tests, as appropriate. Results: Of the 21764 PTB patients registered in 2024, 4977 (22.87%) were identified by active case-finding and 16787 (77.13%) through passive detection. Active detection accounted for a disproportionately large share of students/children (43.55%), people aged ≤14 years (44.75%) and ≥65 years (20.38%). The highest proportions of actively detected cases were observed in Shaoxing (29.73%), Ningbo (28.26%), Jiaxing (25.94%) and Quzhou (23.44%). The proportion of patients was higher in the second (24.15%) and third quarters (25.76%). The median (IQR) care-seeking interval was 11.00 (3.00, 29.00) days for actively detected cases, significantly shorter than the 19.00 (7.00, 40.00) days for passive detection. Conclusion: Active case-finding facilitates earlier diagnosis, shortening care-seeking delays, and preventing disease progression. Resource allocation should be optimized according to local TB epidemiological patterns and active case-finding should be strengthened in high-burden areas and among key populations.

Key words: Tuberculosis, pulmonary, Active detection, Passive detection, Epidemiologic study characteristics as topic, Zhejiang Province

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