2010年全国不同人群和地区新涂阳肺结核登记率与患病率比值分析

Ratio of new smear positive tuberculosis notification and prevalence rate in different population and regions of China in 2010

目的 通过计算2010年全国新涂阳肺结核登记率与患病率的比值,分析其在不同地区和人群中的差异,间接反映不同群体的患者发现情况.方法 使用2010年全国第五次结核病流行病学抽样调查获得的15岁以上人群新涂阳肺结核患病率（52/10万,152/252 940）与我国结核病信息管理系统2010年的登记率数据（39/10万人年,428 214 000/1 088 190 000）,计算登记率与患病率的比值,并对不同性别、年龄、东中西部、世界银行贷款结核病控制项目（也称“卫Ⅴ项目”）省与非卫Ⅴ项目省的新涂阳肺结核登记率与患病率的比值进行直接比较分析.结果 2010年我国15岁以上人群新涂阳肺结核登记率与患病率比值为0.75/人年（39/52）.男性登记率与患病率比值（0.72/人年,55/76）低于女性（0.85/人年,23/27）.各年龄组登记率与患病率比值不一,按10岁一组分组,15～岁组最高（1.55/人年,31/20）,≥75岁组最低（0.43/人年,79/185）.中部省份登记率与患病率比值（1.22/人年,51/42）高于东部（0.95/人年,36/37）,西部最低（0.57/人年,49/85）.卫Ⅴ项目省登记率与患病率比值（0.90/人年,48/53）略高于非卫Ⅴ项目省（0.80/人年,43/50.结论 本研究表明老年人、西部省份登记率与患病率比值较低,提示其患者发现工作仍有较大提升空间;执行现代结核病控制策略时间较长的卫Ⅴ项目省份登记率与患病率比值较高,其患者发现情况更好.

Objective To analyze the case detection situation in different population and regions by calculating ratio of smear positive tuberculosis notification rate and prevalence rate.Methods We used prevalence data obtained from the 5th national tuberculosis prevalence survey （52/100 000,152/252 940） and notification rate obtained from national tuberculosis information management system （39/100 000 person-year,428 214 000/1 088 190 000）,calculated ratio of notification and prevalence rate by gender,age groups,regions and provinces whether implemented world bank funded tuberculosis control project or not,then did direct comparative analysis of them.Results In 2010,the ratio of new smear positive tuberculosis notification rate and prevalence was 0.75 per person-year （39/52） for people over 15 years old.This ratio is lower in male（0.72 per person-year,55/76） than female （0.85 per person-year,23/27）,and varied in different age groups（every 10 years as a group）,highest （1.55 per person-year,31/20）among 15-group and lowest （0.43 per person year,79/185） among ≥75 years of age group.Central provinces had higher ratio of notification and prevalence rate （1.22 per person-year,51/42） than eastern （0.95 per person-year,36/37） and western provinces （0.57 per person-year,49/85）.Ratio of notification and prevalence rate in world bank funded tuberculosis control project provinces （0.90 per-person year,48/53） was higher than non-project provinces （0.80 per person-year,43/54）.Conclusion Our research finds out that the ratio of notification and prevalence rate among elderly patients and in western provinces were relatively low which suggests that we should enhance case detection work among them.Provinces which had implemented world bank funded tuberculosis control project thus started using directly observed treatment short-course strategy longer has higher ratio of notification and prevalence rate which proves they get better performance on case detection.