2011—2020年新疆维吾尔自治区喀什地区结核病登记患者流行病学特征分析

【目的】掌握喀什地区结核病登记治疗现况和特征,为采取针对性防控措施提供科学依据。【方法】通过中国疾病预防控制信息系统的子系统结核病管理信息系统导出2011—2020年喀什地区结核病患者登记信息,采用Stata 12.0软件进行描述性流行病学分析。【结果】2011—2020年喀什地区肺结核患者登记数呈现“先升后降”的趋势,2018—2020年结核病患者登记发病率年均递减率为40.48%。2011—2016年女性登记肺结核患者数高于男性,男女性别比约0.90,2017年男女性别比基本持平(1.00),2018—2020年男性患者数高于女性,性别比分别为1.05、1.20和1.12。随着年龄上升,各年份年龄别登记人数和登记发病率均上升,年龄别登记发病率差异有统计学意义(χ2=547.79,P<0.001)。肺结核登记病例构成比较大的有莎车县(16.43%~23.64%)、英吉沙县(9.51%~13.87%)、喀什市(8.11%~11.40%)、叶城县(6.98%~13.40%)和巴楚县(4.92%~16.65%)。2018年起喀什地区复治比例上升至27.29%,2019年和2020年分别为20.77%和28.39%。多因素分析显示年龄、耐药情况、年份、病原学诊断结果与复治比例有关(均P<0.05)。【结论】2018年以来喀什地区结核病发现和治疗力度加大,疫情明显下降,但仍面临结核病患者登记发病率较高的形势,中老年、耐药、病原学阳性人群是防治的重点人群,易导致复治比例上升,应针对上述人群提出针对性的防控措施。

The Epidemiological Characteristics of Pulmonary Tuberculosis——Kashgar Prefecture,Xinjiang Uygur Autonomous Region,China,2011-2020

Introduction:National Notifiable Disease Reporting System(NNDRS)plays an important role in the early detection and control of tuberculosis(TB)in China.This study analyzed the epidemiological characteristics of pulmonary tuberculosis(PTB)in Kashgar Prefecture,Xinjiang Uygur Autnomous Region,China from 2011 to 2020 to provide a scientific basis for developing TB control strategies and measures in Kashgar.Methods:The data were collected from the NNDRS,which included the geographical distribution,age,sex,occupation,and pathogenic classification of reported PTB cases in 12 counties/cities of Kashgar Prefecture from 2011 to 2020.Descriptive statistics were used to describe the characteristic of PTB epidemic in Kashgar.Results:There were 189,416 PTB cases reported during 2011–2020,with a mean annual PTB case notification rate(CNR)of 451.29/100,000.A rising trend in the rate of reported PTB between 2011 and 2017(χ2 trend=26.09,P<0.01)and a declining trend between 2018 and 2020(χ2 trend=314.44,P<0.01)were observed.The months with the highest reported number of PTB cases were March to May and November to December.The mean annual rate of reported PTB was 451.88/100,000 for males and 450.67/100,000 for females.In addition,19.76%of patients were bacteriologically-confirmed(Bac+)cases(37,425/189,416),and the mean annual Bac+CNR was 89.17/100,000,rising from 64.76/100,000 in 2011 to 139.12/100,000 in 2020(χ^(2)_(trend)=74.44,P<0.01).Conclusions:The CNR of reported PTB in Kashgar showed a significant declining trend in the past three years.Males,elderly population,winter and spring,and farmers as an occupation were the main factors associated with high incidence of tuberculosis in Kashgar.Targeted prevention and treatment of TB should be strengthened in key groups in this region.

新疆维吾尔自治区喀什地区疾病预防控制机构人力资源现状与问题分析

【目的】了解新疆喀什地区和所辖县市两级疾病预防控制(简称“疾控”)中心人力资源配置现状,分析其存在的问题和影响因素,为合理配置人力资源提供科学依据。【方法】2022年2月喀什地区卫生健康委员会组织对喀什地区和所辖12个县市疾控中心开展问卷调查,调查问卷分为机构问卷和个人问卷。【结果】喀什地区两级疾控中心目前核定编制604个,核定编制达标率76.17%;其中有5个县核定编制达标率<60%,现有在编人员524人,空编率为13.25%。地区级疾控中心实际在岗人数85人,县市疾控中心在岗人数中位数为34人。地区级疾控中心人员队伍老龄化严重,45岁以上占67.06%;县市疾控中心则总体呈现年轻化特征,35岁以下年龄组占54.22%。地区及县市疾控中心本科及以上人员分别占31.76%和24.95%,无职称人员分别占32.94%和48.03%,中、高级职称人员分别占57.89%和22.02%。近3年全地区流失人员24人,均为专业技术人员。【结论】喀什地区疾控机构人员编制不足,人员结构不合理,流失现象严重,尤其是地区级疾控中心亟待优化人力资源配置。