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1992-2004年全国儿童新发现的痰涂片阳性肺结核监测与分析
引用本文:Cheng SM,Du X,Xu M. 1992-2004年全国儿童新发现的痰涂片阳性肺结核监测与分析[J]. 中华儿科杂志, 2006, 44(4): 257-261
作者姓名:Cheng SM  Du X  Xu M
作者单位:100050,北京,中国疾病预防控制中心结核病预防控制中心
摘    要:
目的 分析我国0~14岁儿童新发现的痰涂片阳性(简称新涂阳)肺结核患者监测报告现状,了解儿童结核病患病和发现趋势,进一步认识儿童结核病监测的流行病学意义,以及在现代结核病控制策略下,如何重视和加强儿童结核病防治的问题。方法根据1992-2004年全国结核病监测年报中0~14岁儿童新涂阳肺结核患者登记报告资料,分析我国儿童新涂阳肺结核患者占全国新涂阳肺结核患者的比例、新涂阳肺结核患者登记率,分析我国东部、中部、西部和京津沪地区以及除京津沪地区以外,自1992年开始实施现代结核病控制策略(DOTS)的世界银行贷款中国结核病控制项目的13省(简称项目地区)与未实施该策略的另15省(简称非项目地区)的新涂阳肺结核患者登记情况。结果1992-2004年,登记的0~14岁儿童新涂阳肺结核患者31358例,男14727例(47%),女16631例(53%)。占同期新涂阳患者总数的1.26%,男0.89%,女2.03%(P〈0.01)。儿童新涂阳肺结核患者登记率在0.42/10万~1.08/10万之间。在全国不同地区登记的儿童新涂阳肺结核患者中,西部地区占44.9%,其次为中部和东部地区,京津沪占0.9%。除京津沪外,1992年开始实施DOTS策略的项目地区与非项目地区比较,0~14岁儿童新涂阳肺结核患者登记数分别占75%和25%。各年度儿童新涂阳肺结核患者数占总涂阳肺结核患者数的比例,以西部地区最高。结论在登记的儿童新涂阳肺结核患者中,女性儿童新涂阳肺结核患者登记数高于男性,女性儿童新涂阳肺结核患者占女性总新涂阳肺结核患者比例高于男性。西部地区儿童新涂阳肺结核患者数多于中部和东部地区,项目地区多于非项目地区。儿童涂阳肺结核患者的患病和发现,不仅与当地结核病疫情有关,还与是否实施现代结核病控制策略有着密切的关系。

关 键 词:结核 肺 传染病控制 儿童 流行病学方法
收稿时间:2005-12-22
修稿时间:2005-12-22

Surveillance and analysis of the pediatric pulmonary tuberculosis in new smear positive cases from 1992 to 2004 in China
Cheng Shi-ming,Du Xin,Xu Min. Surveillance and analysis of the pediatric pulmonary tuberculosis in new smear positive cases from 1992 to 2004 in China[J]. Chinese journal of pediatrics, 2006, 44(4): 257-261
Authors:Cheng Shi-ming  Du Xin  Xu Min
Affiliation:National Center-for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention,Beifing 100050, China
Abstract:
Objective To analyze the results of surveillance for new smear positive pediatric tuberculosis (TB) cases at the age of 0 to 14 years in China, to understand the trend of prevalence and finding of the new smear positive pediatric cases with TB, to illuminate the significance of surveillance for pediatric TB in TB epidemiology and to explore how to prevent and control pediatric TB with the modern TB control strategy(directly observed treatment,short-course,DOTS).Methods According to the register of new smear positive pediatric TB cases at the age of 0 to 14 years in the National Annual Surveillance Reporting from 1992-2004, the proportion of new smear positive pediatric TB cases among all the new smear positive TB cases in China, the notification rate of new smear positive pediatric TB, the case detection rate of new smear positive TB in the eastern, central and west parts of China, in Beijing, Tianjin and Shanghai municipalities and 13 provinces where the modern TB control strategies have been implemented in 1992 and 15 provinces where the strategies have not been implemented except Beijing, Tianjin and Shanghai municipalities, were analyzed.Results From 1992 to 2004, 31 358 new smear positive pediatric cases with TB at the age of 0 to 14 years were registered, among whom 14 727 were males (47%) and 16 631 were females (53%). The proportion of new smear positive pediatric TB cases among all the new smear positive TB cases was 1.26%, while the proportion among males was 0.89% and among females was 2.03%. The proportion among females was higher than that among males (P<0.01). The notification rate of new smear positive pediatric cases with TB was between 0.42/100 000 and 1.08/100 000. Among the new smear positive pediatric TB cases, 44.9% were from western parts of China, followed by central and eastern parts of China and only 0.9% were from Beijing, Tianjin and Shanghai municipalities. Excluding Beijing, Tianjin and Shanghai municipalities, 13 provinces where DOTS was implemented since 1992 were compared with the other 15 provinces. The notification rate of new smear positive TB was respectively 75% and 25%. Western region of China was listed on the top in the proportion of new smear positive pediatric TB cases among all the new smear positive TB cases in every year.Conclusion Among the registered new smear positive pediatric cases with TB, the number of females was higher than that among females and the proportion among males was also higher than that among males. The number of new smear positive pediatric TB cases in western parts of China was higher than that in central and eastern parts of China and the number in DOTS area was higher than that in non-DOTS area, which meant that the case detection of pediatric TB was associated with TB epidemic and DOTS strategy. Thus, in the implementation of DOTS, strengthening the prevention and control of pediatric TB, tracing the infection source of pediatric TB has certain impact on the TB epidemiological status.
Keywords:Tuberculosis, pulmonary   Communicable disease control    Child   Epidemiotogic methods
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