178例境外卫生机构通报入境肺结核患者信息管理情况分析

Analysis of information management for 178 immigrants notified as pulmonary tuberculosis by health institutions outside China

目的了解境外卫生机构通报的入境肺结核患者信息管理实施现况，为加强境外输入性肺结核防控提供依据。方法采用定量描述性分析方法，利用2007年7月1日至2013年12月31日境外卫生机构通报的肺结核患者监测信息，分析178例患者的基本情况，境外卫生机构和患者入境省份的分布情况，以及追访处理和信息反馈情况。结果耐多药肺结核患者占境外通报患者的14．6％（26／178）。通报患者数位居前三的卫生机构分布在美国、中国台湾和加拿大，共占通报患者总数的83．7％（149／178）；入境患者主要分布在广东省、福建省、上海市、江苏省和北京市等东部省（直辖市），占65．2％（116／178）。61．8％（110／178）的入境患者经各地结核病防治机构追访到位并反馈信息，14．0％（25／178）的患者由于信息不全或者不真实导致失访。东部、中部和西部地区结核病防治机构没有反馈患者信息的比率分别为20．7％（24／116）、36．1％（13／36）和27．8％（5／18）。结论我国面临输入性肺结核特别是耐多药肺结核患者的传播风险，东部地区是重点预防和控制的地区，应有针对性地采取措施，加强境外卫生机构通报和输入性肺结核患者的信息管理工作。

Objective To understand the situation of information management for patients who entered China after they were notified as pulmonary tuberculosis （PTB） by medical institutions outside China, and to provide evi- dences for strengthening TB control among immigration in China. Methods Using a quantitative descriptive analy- sis method, we analyzed the information and data of 178 PTB patients which were provided by the health institutions outside China from 1st July 2007 to 31st December 2013, including the countries where the patients were notified and reported, the provinces that the patients stayed after they entered China, as well as the results of patients tracing, treatment management and information feedback. Results Among 178 reported PTB cases, 14.6% （26/178） of them were muhidrug-resistanee PTB and 83.7%（149/178） of the total patients were reported by the health institu- tions in United States, China Taiwan and Canada, which ranked as the top three counties in terms of the number of reported PTB cases. After the patients entered China, they mainly lived in the eastern part of China, such as Guangdong, Fujian, Shanghai, Jiangsu and Beijing, etc. , which accounted for 65.2% （116/178） of total patients. 61.8% （110/178） of reported patients were successfully reached by tracing of the local TB dispensaries, while 14.0% （25/178） of patients could not be contacted due to insufficient or incorrect contact information. The percew tages of the patients that no any feedback information was received from the local TB institutions were 20.7% （24/116）, 36.1%（13/36） and 27.8% （5/18） respectively in the eastern, middle and western areas of China. Conclusion There is a risk of TB/MDR-TB transmission in China due to the entry of PTB patients, and the eastern part of China should be more concerned. Effective and tailored measures should be adopted to strengthen the infor- mation management for notified PTB cases once they enter the country.