广东省中山市小榄镇痰涂片阳性肺结核患者执行居家隔离措施的现状调查

Investigation of the current situation of patients with sputum smear positive pulmonary tuberculosis under implementation of home quarantine in Xiaolan Town

目的了解广东省中山市小榄镇痰涂片阳性(简称"涂阳")肺结核患者居家隔离措施的执行情况,为肺结核的预防和控制提供科学依据。方法采用横断面调查方法,对小榄镇2011—2012年收治的年龄≥15岁的涂阳肺结核患者共195例进行调查,其中本地户籍59例,非本地户籍136例,男性130例,女性65例,平均年龄39.47±16.88岁,年龄≤45岁者141例,>45岁者54例,文化程度在小学及以下者72例,初中者86例,高中及以上者37例。每例患者均由结核病防治(简称"结防")医生对其进行结核病防治知识核心信息的宣传教育(简称"宣教")和居家隔离措施指导,1个月后再对该患者进行访谈式问卷调查。调查问卷根据《中国结核病防治规划实施工作指南(2008年版)》中的相关内容自行设计,内容包括患者结核病核心信息知晓率及居家隔离措施执行情况。发放问卷195份,回收有效问卷195份,有效率为100.00%。使用Excel软件录入数据,SPSS 13.0软件进行统计学分析,采用χ2检验,P<0.05为差异有统计学意义。结果核心信息知晓率为42.56%(83/195),年龄≤45岁者知晓率为50.35%(71/141),>45岁者为22.22%(12/54),不同年龄间差异有统计学意义(χ2=12.641,P<0.001);文化程度在小学及以下者为16.67%(12/72),初中者为45.35%(39/86),高中及以上者为86.49%(32/37),不同文化程度间差异有统计学意义(χ2=49.223,P<0.001)。在公共场所不戴口罩率为83.08%(162/195),文化程度在小学及以下者不戴口罩率为97.22%(70/72),初中者为83.72%(72/86),高中及以上者为54.05%(20/37),不同文化程度间差异有统计学意义(χ2=32.440,P<0.001)。对日常生活用品不消毒者占87.69%(171/195),文化程度在小学及以下者不消毒率为95.83%(69/72),初中者为90.70%(78/86),高中及以上者为64.86%(24/37),不同文化程度间差异有统计学意义(χ2=23.005,P<0.001)。结论小榄镇涂阳肺结核患者的核心信息知晓率和居家隔离措施执行率与患者的年龄和文化程度有关。年龄越大、文化程度越低的患者上述知晓率和执行率就越低。这部分患者将成为今后工作的重点关注人群。

Objective To explore the implementation of home quarantine for patients with sputum smear positive pulmonary tuberculosis（PTB） in Xiaolan Town,so as to provide scientific evidence for TB control and prevention.Methods Cross-sectional investigation was applied.Patients aged 15years and above diagnosed as sputum smear positive PTB in Xiaolan Town registered from 2011to 2012were investigated.Among the 195cases who met the requirement,there were 59cases with local Hukou and 136cases with non-local Hukou.There were 130male cases and 65female cases.The average age was 39.47±16.88years.One hundred and forty-one cases were 45 years old or below.Seventy-two cases had primary school or lower education experience,86cases graduated at junior high school and 37cases had diploma of senior high school or above.Every patient was guided by a TB control doctor on the core information of TB control and prevention,and home quarantine implementation.A questionnaire survey was conducted face-to-face after a month.The questionnaire was designed according to Guidelines on Implementation o f Chinese Tuberculosis Control Pro g ram,which covered the awareness of core information on TB and home quarantine implementation.One hundred and ninety-five questionnaires were delivered,and 195valid questionnaires were collected,the effective rate was 100.00%.The data were input by Excel software package and analyzed by SPSS 13.0software package.χ 2 test were adopted in the statistical analysis,P0.05was set as the criteria of statistical significance.Results The awareness rate of core information was 42.56%（83/195）,50.35%（71/141） for those 45years and below and 22.22%（12/54） for those above 45years.The difference between two different age groups was statistical significant（χ 2 =12.641,P〈0.001）.The awareness rate for those had primary school and below education level was 16.67%（12/72）,45.35%（39/86） for junior high school level and 86.49%（32/37） for senior high school and above.There was a statistical significance among different educational level groups（χ 2 =49.223,P〈0.001）.83.08%（162/195） patients didn ’ t wear mask in public place,97.22%（70/72） for the group with primary school or below education level,83.72%（72/86） for junior high school level,and 54.05%（20/37） for senior high school and above.There was a statistical significance among different educational level groups（χ 2 =32.440,P〈0.001）.87.69%（171/195） patients didn ’ t disinfect their daily necessities,the rates of different education level were 95.83%（69/72）,90.70%（78/86） and 64.86%（24/37） respectively.The difference was statistical significant among different educational level groups（χ 2 =23.005,P〈0.001）.Conclusion The awareness rate of core information of tuberculosis and the implementation rate of home quarantine were relative to the age and the level of education.The older the patients are,and the lower education level the patients have,the less core information of tuberculosis the patients know,which result in poor implementation of home quarantine.These groups should be the most important targets in the future.