内蒙古察哈尔右翼后旗肺结核病流行病学分析

Epidemiological analysis of pulmonary tuberculosis in Chahar Right Back Banner, Inner Mogolia

目的分析2002─2016年内蒙古自治区察哈尔右翼后旗肺结核病病例的流行病学特征,为结核病的预防控制工作提供依据。方法对2002─2016年全旗结核病门诊收治的疑似结核病病人,依据常规检查、查痰涂片和拍摄X光胸片进行确诊,将检查和检验结果登记在"三本一卡"上,实行医务人员直接面视下为期6个月的短程化疗(DOTS)。结果 2002─2016年全旗共收治疑似结核病病例7 902例,确诊肺结核病2 106例、登记率26.65%,不同年度登记率差异有统计学意义(χ2=50.76,P<0.01);7个乡(镇)均有发病,其中白音查干镇患病数最多(701例),占发病总数的33.29%,其次是贲红镇(335例)、占15.91%,不同乡(镇)肺结核病登记率差异有统计学意义(χ2=124.70,P<0.01);登记率男性(30.77%)明显高于女性(20.32%),差异有统计学意义(χ2=105.39,P<0.01);60岁~组最高(34.68%),其次是40岁~组(26.28%),0岁~组确诊42例、登记率为9.86%,多为15岁以上青少年;随年龄增长,男性(χ2=202.42)和女性(χ2=13.69)登记率均呈上升趋势(均P<0.01);农民患病最多(1 701例),占发病总数的80.77%,登记率也最高(41.19%),差异有统计学意义(χ2=961.23,P<0.01)。结论实施结核病项目15年来,察哈尔右翼后旗各年度肺结核病病人登记率有较大波动;启动新型管理模式后,病人的登记率明显下降;应重点关注40岁以上男性农民,改善居住和生活条件,做到早发现、早诊断、早治疗,提高肺结核病的治愈率。

Objective To analyze the epidemiological characteristics of pulmonary tuberculosis in Chahar Right Back Banner of Inner Mongolia during 2002─2016 and provide basis for prevention and control. Methods All suspected tuberculosis patients in the tuberculosis clinics in Chahar Right Back Banner during 2002─2016 were collected and confirmed according to the routine examination, sputum smear and chest X-ray film. The results of the examinations mentioned above were recorded on three registration books and one treatment card. The six-month treatment as the directly-observed treatment strategy（DOTS） was given to the patients under the doctor＇s observation. Results There were 2 106 confirmed cases among7 902 suspected pulmonary tuberculosis patients in Chahar Right Back Banner during 2002─2016, with the registration rate of 26.65%. The statistical difference was significant within the annual registration rates（χ2=50.76,P〈0.01）. There were patients found in all seven townships, with the most patients（701 case） in the township of Bayanchagan（33.29%） and then in Benhong（335 cases, 15.91%）. The registration rates of pulmonary tuberculoses patients in different townships had statistical difference（χ2=124.70,P〈0.01）. The registration rate was higher in the male（30.77%） than in the female（20.32%）, with statistical difference（χ2=105.39,P〈0.01）, and the highest in the age group of 60 years-（34.68%）, then in group 40 of years-（26.28%）. There were 42 patients confirmed in age group of 0-19 years, with the registration rate of 9.86%, and teenagers over 15-year-old were the dominant. With age growth, the registration rate of the male（χ2=202.42） and female（χ2=13.69） increased, with statistical difference（P〈0.01）. The patients were the most in farmers（1 701）, occupying 80.77% of the total patients and with the highest registration rate of 41.19% and the statistical difference（χ2=961.23, P〈0.01）. Conclusions While the 15-year implementation of the tuberculosis project, the annual registration rates of pulmonary tuberculosis were undulant. The registration rate of the patients went down after the new management model initiated. The male farmers older than 40 years should be paid more attention to for improvement of their living and housing conditions. The early detection, diagnosis and treatment should be provided so as to improve the cure rate of pulmonary tuberculosis.