2014-2017年南宁市农村地区TB/HIV双重感染患者登记变化趋势分析

Changing trend of registration of patients with Mycobacterium tuberculosis and human immunodeficiency virus co-infection in rural areas of Nanning City, 2014-2017

目的分析2014-2017年南宁市农村地区结核分枝杆菌(TB)/艾滋病病毒(HIV)双重感染(简称TB-HIV感染)患者的登记变化趋势,为制定TB-HIV双重感染防控措施提供科学依据。方法整理2014-2017年南宁市所有县的TB-HIV双重感染防治工作年度报表数据,统计分析不同年度、不同地区TB-HIV双重感染患者登记、结核病患者筛查HIV和HIV/艾滋病(AIDS)患者筛查TB的报告登记变化情况,并对登记报告的趋势进行归因和责任分析。结果 2014-2017年,南宁市农村地区TB-HIV感染患者占结核病患者的比例为5.28%,其中,横县TB-HIV感染患者占结核病患者的比例逐年上升(χ~2=24.260,P<0.001),宾阳县TB-HIV感染患者占结核病患者的比例则逐年下降(χ~2=5.518,P<0.05),各县之间2014-2017年总TB-HIV感染患者占结核病患者的比例差异有统计学意义(χ~2=141.132,P<0.001)。2014-2016年,全市TB-HIV感染患者报告数上升了108.97%,其中,HIV/AIDS患者筛查TB登记报告上升150.79%,结核病患者筛查HIV登记报告下降66.67%;马山县HIV/AIDS患者筛查TB登记报告上升了543.75%,横县HIV/AIDS患者筛查TB登记报告上升了933.33%,宾阳县TB筛查HIV报告上升了300%,而HIV/AIDS患者筛查TB登记报告则下降了66.67%。因马山县和横县的HIV/AIDS患者筛查TB登记造成上升的责任比例分别为102.35%和24.71%,因宾阳县的HIV/AIDS患者筛查TB登记造成下降的责任比例为-11.77%。结论 2014-2016年南宁市农村地区TB-HIV感染患者登记快速上升,主要由马山县和横县的HIV/AIDS患者筛查TB登记上升引起。应进一步加强和完善结核病和艾滋病综合服务机制,对专业人员进行技能培训,并采用多种筛查和检测方法,更高质量的发现、治疗现有以及潜在的TB-HIV双重感染者,有效控制结核病和艾滋病疫情的蔓延。

Objective To analyze the changing tendency of registration of patients with Mycobacterium tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection (abbreviated as TB-HIV co-infection) in rural areas of Nanning City from 2014 to 2017, and to develop a scientific basis for formulating prevention and control measures of TB-HIV co-infection. Methods The data concerning annual reports on prevention and treatment of TB-HIV co-infection in all counties of Nanning City during 2014-2017 were collected. The changing trends of registration reports of TB-HIV co-infection patients in different years and different regions, TB patients with HIV/AIDS screening and HIV/AIDS patients with TB screening were statistically analyzed, and then the causal attribution and responsibility analyses of changing trends of registration reports were performed. Results The proportion of TB-HIV co-infected patients in rural areas of Nanning City during 2014-2017 accounted for 5.28% of the TB patients. Among the TB patients, the proportion of TB-HIV co-infected patients in Heng County increased year by year (χ2=24.260, P<0.001), but TB-HIV co-infected patients in Binyang County decreased with years (χ2=5.518, P<0.05). Among the TB patients, the differences in the proportions of total patients with TB-HIV co-infection in different counties in 2014-2017 showed statistically significant (χ2=141.132, P<0.001). The number of reported cases of TB-HIV co-infection in Nanning City in 2014-2016 increased by 108.97%, of which the registration reports of HIV/AIDS patients with TB screening increased by 150.79%, but the registration reports of TB patients with HIV screening decreased by 66.67%. The registration reports of HIV/AIDS patients with TB screening in Mashan County and Heng County increased by 543.75% and 933.33% respectively. The registration reports of TB patients with HIV/AIDS screening in Binyang County increased by 300%, while those of HIV/AIDS patients with TB screening decreased by 66.67%. The proportions of responsibility for the increase in the registration reports of HIV/AIDS patients with TB screening in Mashan County and Heng County were 102.35% and 24.71% respectively, while the proportion of responsibility for the decrease in the registration reports of HIV/AIDS patients with TB screening in Binyang County was -11.77%. Conclusions The registration of TB-HIV co-infected patients in rural areas of Nanning City during 2014-2016 increased rapidly mainly because of the increase in screening for TB among HIV/AIDS patients in Mashan County and Heng County. We should further strengthen and improve the comprehensive service mechanism for TB and AIDS, conduct skill training for professionals, adopt a variety of screening and detection methods to achieve a higher quality of detection and treatment of existing and potential TB-HIV co-infection, and effective control the spread of TB and AIDS epidemics.