| 云南省病原学阳性肺结核患者总延迟变化趋势 |
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| 引用本文： | 律彤,杨蕊,陈金瓯,李玲,邱玉冰,许琳.云南省病原学阳性肺结核患者总延迟变化趋势[J].中华疾病控制杂志,2022,26(5):547-553. |
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| 作者姓名： | 律彤 杨蕊 陈金瓯 李玲 邱玉冰 许琳 |
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| 作者单位： | 1.650500 昆明，昆明医科大学公共卫生学院 |
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| 摘 要： | 目的 分析“十一五”“十二五”和“十三五”中国结核病防治规划期间云南省病原学阳性肺结核患者总延迟时间的变化趋势，获得影响总延迟发生的影响因素，为减少总延迟的发生提供依据。 方法 利用《结核病管理信息系统》中登记报告的云南省2005年、2010年、2015年和2020年病原学阳性肺结核患者的病案资料。描述最终纳入研究患者的人口学特征、延迟特征。构成比的时间趋势检验用χ2趋势检验，采用Kaplan-Meier法进行组间患者总延迟的比较，估计生存概率并绘制生存函数曲线，用Cox比例风险模型进行患者总延迟发生的多因素分析。 结果 云南省病原学阳性肺结核患者的总延迟整体呈下降趋势，且下降趋势与就诊延迟相似。总延迟中位数由2005年的94 d降至2020年的33 d，2020年患者确诊并接受治疗的概率较2005年增长了2.359倍，不同特征患者的总延迟天数均呈下降趋势。多因素回归分析结果显示，除年份外，女性、高年龄、农民、少数民族、流动人口和复治患者也是发生总延迟的危险因素。 结论 在云南省结核病防控措施的实行下，病原学阳性肺结核患者总延迟天数下降，有效控制了结核病疫情的发展。应侧重于降低总延迟天数较高的危险人群的就诊延迟, 寻求符合成本-效益的主动筛查方式，进一步控制结核病疫情发展。
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| 关 键 词： | 肺结核 病原学阳性 总延迟 趋势分析 云南省 |
| 收稿时间： | 2021-08-12 |
Analysis of the trend of total delay among pulmonary tuberculosis patients with positive etiology in Yunnan Province |
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| LYU Tong,YANG Rui,CHEN Jin-ou,LI Ling,QIU Yu-bing,XU Lin.Analysis of the trend of total delay among pulmonary tuberculosis patients with positive etiology in Yunnan Province[J].Chinese Journal of Disease Control & Prevention,2022,26(5):547-553. |
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| Authors: | LYU Tong YANG Rui CHEN Jin-ou LI Ling QIU Yu-bing XU Lin |
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| Affiliation: | 1.School of Public Health, Kunming Medical University, Kunming 650500, China2.Tuberculosis Prevention Center, Yunnan Center for Disease Control and Prevention, Kunming 650022, China |
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| Abstract: | Objective To analyze the trend of total delay of tuberculosis patients with positive etiology in Yunnan Province during the 11th five-year Plan, 12th five-year Plan and 13th five-year Plan for tuberculosis prevention and control, and to obtain the influencing factors of total delay, so as to provide the basis for reducing the occurrence of total delay. Methods Via the tuberculosis management information system(TMIS), we collected medical records of patients with pathogen-positive pulmonary tuberculosis registered in Yunnan Province in 2005, 2010, 2015 and 2020. The demographic characteristics and delay characteristics of the study participants were described. χ2 trend test was used for the time trend test of rate and composition ratio, and the Kaplan-Meier method was used to compare the total delay between groups, and the survival probability was estimated and drawn as a survival function curve. Cox proportional hazard model was used for multivariate analysis of total delay. Results The total delay of positive etiology pulmonary tuberculosis patients in Yunnan Province has declined, and the declining trend was similar to patient delay. The median total delay was reduced from 94 days in 2005 to 33 days in 2020. The probability of patients with pathogenic positive pulmonary tuberculosis being found and receiving treatment in 2020 increased by 2.359 times compared with 2005, and the total delay days of patients with different characteristics showed a downward trend. Multivariate regression analysis showed that besides years, women, older age, farmers, ethnic minorities, floating population and retreatment patients were also risk factors for the total delay. Conclusions With the implementation of tuberculosis prevention, and control measures in Yunnan Province, the total delay days of patients with positive pathogenic tuberculosis decreased significantly, which effectively controlled the development of tuberculosis epidemic. To further control the development of the tuberculosis epidemic, we should pay attention to the risk groups with long total delay days, and seek cost-effective active screening methods to reduce the patient delay of dangerous people. |
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