天津市慢性乙型病毒性肝炎跨年度重复报告情况分析

Cross-year duplicate reports of chronic hepatitis B in Tianjing

目的了解天津市慢性乙型肝炎跨年度重复报告数量及对报告发病率的影响,以规范慢性肝炎报告标准。方法应用Microsoft Excel程序对国家疾病监测信息报告管理系统的天津市乙型肝炎疫情数据库作前期处理,根据患者的姓名、性别和年龄3个主要字段进行查重,其要求是姓名、性别完全相同,年龄±3岁,姓名同音不同字。运用函数提取姓名的1、2、3字分别放在3个单元格内,同时把每个汉字转成拼音附后单元格内,年龄转成数值型,运用Access查询功能汇总分析。用卡方统计分析组间差异。结果2007年1-4月份慢性乙型肝炎病例与2004、2005、2006年比较累计重卡率为28.76%(700/2434),分年度重卡率分别为6.57%、11.79%和17.09%;其中姓名、性别相同,年龄基本一致的累计重卡率为24.24%;姓名同音不同字累计重卡率为4.52%,二字姓名重卡率(10.65%)高于三字姓名(3.37%),差异有统计学意义(!2=39.827,P<0.01)。由于重卡(跨年度重复报告)致2007年报告发病率上升幅度较2006年同期增加32个百分点。结论制订慢性肝炎报告标准是当务之急。

Objective The study was conducted to analyze the number of cross-year duplicates of previously recorded chronic hepatitis B cases and its impact on the reported incidence, in order to standardize the criteria for the reporting of chronic hepatitis. Methods Microsoft Excel was used to pretreat the database of Tianjing＇s hepatitis B epidemic maintained by the National Disease Surveillance Report Management System. Duplicate records were checked in accordance with three main fields, i.e. patient＇s name, gender and age. To specify duplicate records, these criteria were followed： 1. identical name and gender, difference of age ± 3 years; 2. names were homonym of different characters, for others, ditto. The first three characters of the name field were respectively extracted into three cells, to which additional cells containing each character＇s Chinese pinyin were appended. Age values were converted into numeric type. A meta-analysis was eventually performed based on the query function of Access, intergroup differences analyzed using Chi-square analysis. Results The cumulative duplicate rate of chronic hepatitis B cases reported from Jan. to Apr. in 2007 was 28.76% （700/2434） compared with the data in 2004, 2005 and 2006, the respective annual rate being 6.57%, 11.79% and 17.09%. For entries with identical name and gender and similar age, the cumulative duplicate rate was 24.24%; for entries with homonymic name of different characters, the cumulative duplicate rate was 4.52%. The duplicate rate of two-character names （10.65%） was higher than that of three-character names （3.37%）, with statistically significant difference（χ^2= 39.827, P〈0.01）. The increase of the incidence rate reported in 2007 was 32% higher than the increase of the reported incidence rate in the same period, 2006 due to these duplicates （cross-year duplicate reports）. Conclusion Established criteria for the reporting of chronic hepatitis are top-priority required.