广州市番禺区2011--2015年流动人口肺结核流行特征

Epidemic characteristics of tuberculosis among migrating population in Panyu District,Guangzhou,2011-2015

目的通过对2011—2015年广州市番禺区流动人口肺结核病流行特征的分析,探索更好的流动人口结核病疫情控制方法。方法采用描述性统计分析的方法对肺结核病患者流行特征的各项指标进行分析。结果登记的患者人数从2011年的769例下降到2015年的416例,减少了45.90%,2011—2015年菌阳比例为40.30%,从2011年的34.46%上升到2015年的45.43%,上升了31.83%。患者主要为男性青壮年,占61.01%,未填写职业、民工、无业人员,占93.96%;多属于首次发病,占96.39%;发病后以综合医院转诊发现(72.60%)和直接因症到结防机构就诊(17.97%)为主;病人不及时就诊延误率(52.60%)和未及时确诊率(18.47%)较高;初治涂阳患者2月末阴转率为84.21%,复治涂阳为72.00%;涂阳患者系统管理率为86.80%,治疗成功率为84.97%,丢失率为10.54%。结论针对我区流动人口肺结核病存在发病高、发现晚、系统管理难等特点,区结防机构、社区卫生服务中心和企业等更应将流动人口结核疫情视作本地疫情,互相协助,为流动人口提供与本地户籍人口同样的健康均等化服务,采取包括主动入厂宣传、免费提供可疑者筛查、上门访视患者、提供人文关怀等服务措施,以促进我区流动人口结核病疫情的有效控制。

Objective To understand the epidemic characteristics of tuberculosis（TB） among the migrating population in Panyu District,Guangzhou City from 2011 to 2015,so as to explore better control measures. Methods The indexes of epidemic characteristics of TB patients were analyzed by using the descriptive statistics analysis method. Results The registered TB cases declined from 769 in 2011 to 416 in 2015,with the decreasing rate of 45.90%. The average ratio of bacteria positive was 40.30% from 2011 to 2015,and the ratio of bacteria positive rose from 34.46% in 2011 to 45.43% in 2015,with the rise rate of 31.83%. The main patients were male youths（61.01%）,including the persons who did not fill in the employment,migrant workers and unemployed people（93.96%）. The first onset accounted for 96.39%. The main cases were persons having symptoms referred from general hospitals（72.60%）,and the people with symptoms seeing doctor directly to TB prevention and control institutions（17.97%）. The delay rate of the patients seeing doctor was 52.60% and the failing rate of timely confirmed diagnose was 18.47%. The sputum negative conversion rate within 2 months was 84.21% among initial smearpositive patients,and it was 72.00% among the retreatment smear-positive patients. The system management rate was 86.80%among the smear-positive patients. The treatment success rate was 84.97%,and the loss rate was 10.54%. Conclusion In allusion to the characteristics of high incidence,late discovering,and system management difficulty of tuberculosis among the migrating population,TB prevention and control institutions,community health service centers and enterprises should pay more attention to the tuberculosis epidemic among migrating population and strengthen the free screening for suspicious patients,door to door visiting patients,and other service including humanistic care,so as to effectively control the TB epidemic.