2009-2018年北京市肺结核患者发现和治疗管理效果分析

Analysis on the effectiveness of detection and treatment management of tuberculosis patients in Beijing,2009-2018

目的评估2009-2018年北京市肺结核患者发现和治疗管理工作效果,为今后优化防治策略措施提供依据。方法通过现场专项调查、"传染病监测系统"和"结核病管理信息系统"收集肺结核患者发现、报告、转诊、治疗管理及转归等资料,采用SAS 9.2软件进行分析,组间比较采用χ^2检验,率的时间趋势采用Cochran-Armitage趋势性检验,P<0.05为差异有统计学意义。结果 2009-2018年,不同年份非结核病定点医疗机构肺结核患者报告率、转诊率差异有统计学意义,转诊率随年份增加(Z=12.16,P<0.001);非结核病定点医疗机构报告肺结核患者的总体到位率随年份增加(Z=47.88,P<0.001);报告肺结核患者的登记管理率在2009-2013年下降(Z=-12.74,P<0.001),在2014-2018年上升(Z=36.54,P<0.001);登记管理肺结核患者的治疗成功率随着年份增加(Z=6.25,P<0.001);肺结核报告发病率随年份降低,年递降率为4.80%(Z=-40.31,P<0.001)。结论北京市2009-2018年肺结核患者发现和治疗管理工作效果明显,肺结核疫情缓慢平稳下降。

Objective To evaluate the effectiveness of detection and treatment management of tuberculosis (TB) patients in Beijing,2009-2018,and to provide references for TB prevention and control.Methods Data on the TB case detection,report,referral,treatment management and outcome were collected from special work field investigation,"infectious disease surveillance system"and"tuberculosis management information system"that affiliated to the China information system for disease control and prevention.Statistical analysis was performed by SAS 9.2 software.Rates were compared by χ^2 test.The time trend of rate was analysed by Cochran-Armitage trend test.P<0.05 was considered as statistically significant.Results The annual differences of case report rate,referral rate of health facilities other than TB control institutions were statistically significant during 2009-2018.Both referral(Z = 12.16,P<0.001) and general arrival rates(Z = 47.88,P<0.001) increased significantly every year.The registered management rate decreased annually from 2009 to 2013(Z =-12.74,P<0.001),and then increased annually from 2014 to 2018(Z = 36.54,P<0.001).The success treatment rate increased annually(Z = 6.25,P<0.001).The reported incidence declined evey year(Z =-40.31,P< 0.001),and the annual rate of decline was 4.80%.Conclusions In 2009-2018,the TB detection and treatment management in Beijing was slightly effective,and the TB epidemic strenghth decreased slowly but stablized.