丹阳市2009—2012年外来人口肺结核监测结果分析

Tuberculosis monitoring of migrant population in Danyang city in 2009-2012

目的通过外来人口肺结核随访监测,了解外来人口肺结核流行特征和诊治延误现状,为探寻降低肺结核患病率的有效措施提供依据。方法 2009—2012年每年对外来人口集中场所和村卫生室开展一次随访监测和健康教育,了解有无肺结核可疑症状者和患者。对辖区内管理的肺结核患者进行户籍地调查,掌握外来人口发病情况。做好疑似病例诊断,收集肺结核专报数据和确诊患者诊疗信息,进行患病率和诊疗延误分析评估,计数资料采用χ2检验,P〈0.05为差异有统计学意义。结果 4年监测外来人口586 342人,登记肺结核患者383例,其中新涂阳肺结核157例。外来人口肺结核、新涂阳肺结核年均标化患病率分别为84.86/10万、36.50/10万,其中男性肺结核、新涂阳肺结核患病率（分别为：82.59/10万、34.36/10万）均明显高于女性（分别为：42.81/10万、16.89/10万）。农民工为主要患病人群,15~24岁组与≥65岁组患病率相对较高,患者诊疗延误主要发生在就诊阶段,就诊延误率达57.70%,出现可疑症状到就诊平均34.63 d。结论目前外来人口肺结核防控仍不容忽视,年轻民工和老年人应是防治重点对象,需加强针对性宣传教育、主动监测和归口诊治,做到早发现、早诊断、早治疗。

Objective The purpose of this study was to understand the epidemic features of tuberculosis and the present situation of delayed diagnosis and treatment of tuberculosis through follow-up monitoring among migrant population,so as to provide a basis for exploring effective measures to reduce the prevalence of tuberculosis.Methods A follow-up monitoring and health education were conducted annually in public places where migrant population gathered and in village clinics,to find tuberculosis suspects and patients.Tuberculosis patients living in jurisdictions were investigated for their residential place to make clear tuberculosis prevalence among mingrant population.Diagnosis should be made for tuberculosis suspected cases.The data of special reports and the information of patients diagnosed as tuberculosis should be collected so as to assess of prevalence and delayed diagnosis and treatment.Measurement data by chi-square test,the result of P〈0.05 was considered statistically significant.Results A total of 586 342 migrant individuals were monitored in the past 4 years,383 were found to have tuberculosis,including 157 cases of newly found smear-positive pulmonary tuberculosis.For migrant population,the annual standardized prevalence of tuberculosis and newly-found smear-positive tuberculosis was 84.86/10^5 and 36.50/10^5,respectively.Furthermore,the prevalence of tuberculosis and newly-found smear-positive tuberculosis was 82.59/10^5 and 34.36/10^5 for males,which were obviously higher than those of females（42.81/10^5,16.89/10^5）.The major vulnerable groups were migrant workers.The prevalence rate was relatively higher in group aged15-24 years and group aged ≥65 years.Diagnosis and treatment delays mainly occurred in the stage of seeking for medical attention,the rate of treatment delay was up to 57.70%.It usually took an average of 34.63 days for them to seek for medical attention since the occurrence of suspicious symptoms.Conclusion Currently,the prevention and control of tuberculosis among migrant population can not be ignored,especially the younger migrant workers and the elderly.Targeted education,active monitoring and tuberculosis convergence treatment should be strengthened so as to make early detection,diagnosis and treatment possible.