深圳市宝安区流动人口结核病防治工作现状调查

Survey of the TB control work status of floating population in Bao'an district of Shenzhen city

目的了解深圳市宝安区流动人口结核病疫情特征、治疗管理现状和存在的问题。方法收集了2004—2007年宝安区慢性病防治院登记的结核病患者的个案数据库资料,登记患者3027例,其中常驻人口患者796例,流动人口患者2231例,分析流动人口结核病疫情特征;通过定性访谈方法,访谈了结核病患者9例,结核病门诊和防治医生6名,负责流动人口结核病防治管理的卫生行政和业务部门领导和专家10名,分析了流动人口结核病患者的卫生需求、求医行为,结核病诊断、治疗管理和防治政策方面的现状、问题和建议。结果 2004—2007年宝安区登记的流动人口患者是常驻人口患者的2.8倍(2231/796)。流动人口患者因症就诊比例平均为6.05%(135/2231),转诊比例平均为93.32%(2082/2231)。流动人口新涂阳患者以15～45岁为主,平均为93.80%(1739/1854)。流动人口新涂阳患者督导管理以全程督导为主,2007年为97.93%(663/677),3个月末累计痰菌阴转率为92.99%(1724/1854),由于疗程结束时无转归结果患者比例高,新涂阳患者的治愈率平均为46.33%(859/1854)。结论深圳市宝安区登记的流动人口患者高于常驻人口,流动人口的高流动性给治疗管理工作带来了一定难度,疗程结束时失访患者比例高,因此,应加强患者治疗管理和转归信息的衔接和共享。

Objective To understand the TB control work status of floating population in Bao’an district of Shenzhen. Methods We collected the case-based database of pulmonary TB cases registered from 2004 to 2007 in Bao’an chronic disease hospital.A total of 3027 cases were registered,among which 796 cases were of resident po-pulation,and 2231 were of floating population.We analyzed the features of TB epidemic in floating population.We also interviewed nine cases of TB patients,six TB doctors,and ten health administration leaders responsible for floating population TB management.Through the interview,we analyzed the health demand of floating population TB patients,their health seeking behavior and current status in their TB diagnosis,treatment,management and control policy. Results The number of pulmonary TB cases registered in floating population was 2.8 times（2231/796） of that in resident population.6.05%（135/2231）of TB patients were detected by passive case identification in floating population,the referral rate was 93.32%（2082/2231）.Patients aged between 15 to 45 years old predominated in new smear positive patients was 93.80%（1739/1854）.Case management was mainly through full-course management,97.93%（663/677） for new smear positive pulmonary TB patients in 2007,the accumulative smear conversion rate at the end of third month was 92.99%（1724/1854）.The cure rate was 46.33%（859/1854）because high proportion of patients missed treatment outcome information in the end. Conclusion The number of TB registration in floating population is higher than in resident population,however,a large proportion of patients were loss to follow-up at the end of treatment.Therefore,we should strengthen the treatment management of TB patients and information connection and sharing.