结核病防治从业人员对新的结核病标准相关知识知晓情况调查分析

Analysis of the awareness about knowledge on the updated TB diagnosis standard among the practitioners in TB control institutions

目的了解结核病防治(简称"结防")从业人员,即定点医疗机构医务人员和疾病预防控制(简称"疾控")机构结防人员对"新标准"《WS 196—2017结核病分类》和《WS 288—2017肺结核诊断》主要内容的掌握情况,提出进一步落实"新标准"的相关措施建议。方法本研究采用现况调查的方法,根据地域分布确定了5个研究省(自治区),选择4个地市级、9个县区级结防机构。对结核病定点医疗机构的临床诊断、管理人员及当地疾控机构的325名结防人员进行问卷调查。调查内容主要围绕2个"新标准"主要技术更新,涉及相关核心信息共10条。发出问卷325份、收回问卷325份、有效问卷325份,对计数资料主要采用描述性统计学方法和χ~2检验。以P<0.05为差异有统计学意义。结果结果显示,疾控机构人员(87.8%,202/230)和定点医疗机构的医生(85.1%,1455/1710)的总知晓率均高于管理人员(76.3%,1000/1310),差异均有统计学意义(χ~2值分别为15.078、37.357;P值均为0.000)。10条信息的总知晓率为81.8%(2657/3250)。其中第10条"新诊断标准中哪些部位的结核病变需要执行肺结核管理原则的登记和报告"的知晓率最高,为93.5%(304/325);第6条"非活动性肺结核如何判定"的知晓率最低,为73.2%(238/325)。结论通过问卷调查,结果显示13个结核病定点医疗机构的医务人员和疾控人员对2个"新标准"知识的认知不全面,为有效控制我国结核病疫情,加强对"新标准"相关知识的培训至关重要。

Objective To learn the understanding on the major contents of Standard WS 196—2017 Classification of tuberculosis and WS 288—2017 Diagnosis for pulmonary tuberculosis among parctitioners in the TB control,or medical staff in designated medical institutions and/or TB control staff in the center for disease control and prevention at the survey sites,and propose measures to further implement the new standards. Methods This was a cross-sectional study,including 5 provinces(autonomous region)selected according to geographical distribution and previous work on TB control,including 4 prefectures(cities),9 counties(districts).A questionnaire was used to investigate staff working on management and clinical diagnosis in designated medical institutions and center for disease control and prevention.The main content of the questionnaire was about technical updates on the two new standards,involving a total of 10 questions related to core information.Totally 325 questionnaires were distributed,325 were retrieved.Collected data were statistically analyzed and verified usingχ~2.P<0.05 was considered statistically significant difference. Results The results showed that the total awareness rate of staff in center for disease control and prevention(87.8%,202/230)and doctors in designated medical institutions(85.1%,1455/1710)were higher than other personnel(76.3%,1000/1310),and the difference was statistically significant(χ~2 value were 15.078,37.357 respectively;All Pvalue were 0.000 respectively).The total awareness rate of all the information was 81.8%(2657/3250),of which the awareness rate of the 10 th piece"Which part of the tuberculosis lesions in the new diagnostic criteria need to be registered and reported in accordance with the principles of tuberculosis management"was the highest,at 93.5%(304/325),while awareness rate of the6 th piece"How to diagnose non-active tuberculosis"was the lowest,at 73.2%(238/325). Conclusion This study showed that staff in 13 designated medical institutions and center for disease control and prevention did not fully understand these two new standards.In order to effectively control TB epidemic in China,it is essential to strengthen the effective promotion and implementation of the new standards.