2016-2019年青川县60岁及以上常住居民结核病主动发现效果分析

Effect of Active Detection in Elderly Patients with Tuberculosis

目的通过对2016-2019年青川县常住6个月以上60岁及以上居民开展入户面对面结核病可疑症状筛查及后续检测诊断,了解主动发现在老年人群的结核病防控中的实践意义。方法在2016-2019年组织经过培训的工作人员对青川县常住6个月以上60岁及以上居民开展入户面对面结核病可疑症状筛查,对发现肺结核可疑症状者推荐到乡镇中心卫生院进行胸部X线摄片检查,收集痰标本进行痰涂片与痰培养检查并确诊,比较主动发现与被动发现患者的年龄、性别、职业和菌阳率等情况,分析患者的特征。率的比较采用χ^(2)检验及χ^(2)趋势检验,以P<0.05为差异有统计学意义。结果2016-2019年期间共计完成60岁及以上人群结核病症状筛查95202人次,发现结核病可疑症状者5970人(6.27%,5970/95202);其中男性可疑症状发生率(7.99%)高于女性可疑症状发生率(3.79%)(P<0.05);农民可疑症状发生率(6.77%)高于非农民可疑症状发生率(3.14%)(P<0.05);可疑症状发生率随年龄的增长而增长(χ^(2)趋势=999.25,P<0.001)。后续确诊活动性结核病患者176例,可疑症状者活动性肺结核检出率为2.95%(176/5970),其中不同性别、职业人群的检出率差异无统计学意义(P>0.05);不同年龄组结核病可疑症状者中的检出率差异有统计学意义(P<0.05),且检出率随年龄的增长而降低(χ^(2)趋势=13.33,P<0.001)。主动与被动两种发现方式下患者的年龄分布与痰菌检出结果差异有统计学意义(P<0.05),职业与性别构成差异无统计学意义(P>0.05)。结论在贫困地区为60岁及以上老年人群开展结核病主动筛查,能够早期发现活动性结核病患者,提高老年结核病患者发现率。

Objective To explore the effect of active detection in tuberculosis prevention and control of the elderly population through the household face-to-face TB screening and follow-up detection and diagnosis for residents aged 60 years and above who lived in Qingchuan county over 6 months from 2016 to 2019.Methods In 2016 to 2019,trained staff were organized to conduct face-to-face TB screening among residents aged 60 years and above who lived in Qingchuan county over 6months.Those who had suspicious symptoms of tuberculosis were recommended to Township Central Health Centers for chest X-rayexamination,sputum smear,and sputum culture examination.Age,sex,occupation and bacteria positive rate of patients were compared between the active discovery and passive discovery.The rates were compared by usingχ^(2)andχ^(2)trendtests.P<0.05 was considered as statistically significant.Results During 2016 to 2019,a total of 95202 people aged 60 years and above were screened for TB symptoms,and 5970(6.27%,5970/95202)were found to have TB suspicious symptoms.The detection rate of suspicious symptoms in men was higher than that in women(7.99%vs.3.79%,P<0.05).The detection rate of suspicious symptoms in farmers was higher than that in non-farmers(6.77%vs.3.14%,P<0.05).The incidence of suspicious symptoms increased with age(χ^(2)trend=999.25,P<0.001).The detection rate of active tuberculosis was 2.95%(176/5970),and there was no significant difference in the detection rate of different sexes and occupations(P>0.05).The detection rate of suspicious symptoms in different age groups was statistically significant(P<0.05),and the detection rate decreased with age(χ^(2)trend=13.33,P<0.001).Conclusion With the support of the project,active TB screening can be used for the elderly aged 60 years and above in poor areas,which can early detect active TB patients and improve the detection rate of elderly TB patients.