2016-2021年开封市某县肺结核患者发现状况及新型冠状病毒感染疫情对患者发现的影响

Status of tuberculosis patient detection and the impact of COVID-19 on patient detection in a county of Kaifeng city from 2016 to 2021

目的探索肺结核患者早发现及新型冠状病毒感染疫情对尉氏县肺结核患者发现的影响,助推结核病疫情控制。方法依据中国疾病预防控制信息系统“结核病信息管理系统”,对2016-2021年尉氏县肺结核患者就诊和登记情况进行分析。结果2016-2021年共登记肺结核2707例,其中被动和主动发现肺结核患者分别占98.08%和1.92%,主、被动发现构成各年间差异无统计学意义(χ^(2)=7.57,P=0.181);肺结核患者登记率从2016年的66.78/10万下降到2021年的33.66/10万,呈逐年下降趋势(χ趋势2=156.75,P<0.001);新冠疫情后(2020-2021年)登记率年递降率平均为20.88%,高于疫情前(2016-2019年)登记率年递降率(6.97%);新冠疫情后肺结核患者就诊延误率(40.94%)明显高于疫情前(17.11%)(χ^(2)=177.10,P<0.001)。结论肺结核患者的发现仍然是被动发现为主,主动发现明显不足。新冠疫情对肺结核发现造成较大影响,导致结核患者发现减少,就诊延误率增加;结合新冠疫情控制的同时,兼顾肺结核患者的及时发现,并着力加强主动发现患者力度,以加快终结肺结核流行进度。

Objective To explore the early detection of tuberculosis patients and impact of COVID-19 on the detection of tuberculosis patients in Weishi county,and contribute to the control of tuberculosis epidemics.Methods Based on the TB Information Management System,Chinese Disease Prevention and Control Information System,the consultations and registrations of TB patients in Weishi county from 2016-2021 were analyzed.Results A total of 2707 TB cases were registered from 2016 to 2021,of which 98.08%and 1.92%were passively and actively detected respectively,with no statistically significant difference in active detection composition among years(χ^(2)=7.57,P=0.181);the registration rate of TB patients decreased from 66.78/100000 in 2016 to 33.66/100000 in 2021,showing a decreasing trend year by year(χ^(2)trend=156.75,P<0.001);the annual decreasing rate of registration rate during the pandemic of COVID-19(2020-2021)was on average 20.88%,higher than that before the pandemic of COVID-19(2016-2019)(on average 6.97%);the delayed attendance of TB patients after the COVID 19 was 40.94%,significantly higher than that before the pandemic(17.11%)(χ^(2)=177.10,P<0.001).Conclusions The detection of TB patients is still predominantly passive,and active detection is significantly inadequate;the pandemic of COVID-19 has had a significant impact on TB detection,resulting in a decrease in TB patient detection and an increase in the delayed attendance rate;it should be combined with the control of COVID-19 to detect TB cases in time while strengthening active detection,for accelerating the progress of ending pulmonary tuberculosis epidemic.