Analysis on referral and tracing of tuberculosis cases reported from network by non-TB control institutions in Anhui Province during 2008-2014
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摘要: 目的 分析安徽省2008-2014年非结防机构肺结核患者网络报告、转诊与追踪情况,探索提高结核病患者发现水平的措施,为加强结核病防治工作提供科学依据。方法 收集、整理安徽省2008-2014年结核病网络直报数据及同期报表,患者相关登记本,进行统计分析。结果 2008-2014年非结防机构报告结核病患者和疑似患者250 226例,总体到位227 694例,总体到位率为91.00%,到位病例中确诊为活动性肺结核患者102 154例,其中初治涂阳48 315例,占活动性肺结核患者的47.30%,复治涂阳3 017例,占2.96%,涂阴患者47 823例,占46.81%。与2008年比较,2014年患者转诊率提高了50.74%(χ2=20 915.98,P<0.001),转诊到位率总体呈下降趋势,追踪率提高了31.49%(χ2=7 323.37,P<0.001),追踪到位率提高了31.56%(χ2=5 206.08,P<0.001),总体到位率提高了24.85%(χ2=7 230.69,P<0.001)。追踪未到位原因中以外出所占比例最高,占23.23%,其次为拒绝就诊,占16.31%,查无此人占9.76%,死亡占7.78%,另有42.92%的患者原因不明。结论 非结核病防治机构在肺结核防治中起着重要作用,加强医防合作,完善肺结核患者转诊、追踪制度,将有助于进一步提高病人发现水平。Abstract: Objective To analyze the status of referral and tracing of tuberculosis (TB) cases reported via internet by non-TB control institutions in AnHui province from 2008 to 2014, and to explore measures for improving tuberculosis cases finding and provide scientific basis for TB prevention and control program. Methods Data report forms and records of patient TB registration from 2008-2014 were collected and analyzed. Results 250 226 patients with suspected tuberculosis were reported by the non-TB control institutions in AnHui province from 2008 to 2014, the total arrival rate was 91%, 102 154 cases were diagnosed with active tuberculosis, among whom 48 315 were initial smear-positive cases, accounting for 47.30% of the patients with active tuberculosis, 3 017 were retreatment smear-positive tuberculosis cases, accounting for 2.96%, 47 823 were smear-negative patient cases, accounting for 46.81%. Compared with 2008, patients with referral rate increased by 50.74% (χ2=20 915.98,P<0.001), tracking rate increased by 31.49% (χ2=7 323.37,P<0.001), referral arrival rate increased by 31.56% (χ2=5 206.08,P<0.001), the total arrival rate increased by 24.85% (χ2=7 230.69,P<0.001) in 2014.Among the referral from China TB Direct Report System, the TB cases which could not be traced, the highest proportion of patients went out, accounting for 23.23%, 16.31% cases refused treatment, 9.76% cases were not found, deaths accounted for 7.78%, 42.92% cases were not followed-up for unknown reasons. Conclusions Non-TB control institutions play an important role in TB prevention and control program. TB case detection by enhancing the collaboration with non-TB control institutions and improving TB suspect referring and tracing system will further improve the ability of identifying patients.
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Key words:
- Tuberculosis /
- Patient referral /
- Epidemiologic methods
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