2002—2013年广西肺结核病疫情变化趋势分析

目的 分析2002—2013年广西肺结核病疫情态势,评价广西结核病发现工作质量。方法 利用2002—2013年广西结核病网络专报系统及对容县、兴业县、富川县、昭平县、苍梧县、藤县等6县结核病防治工作现场督导资料,统计分析各年活动性肺结核登记率、新涂阳登记率及其占同期活动性肺结核登记率的比例和各年发现率,现场抽检6县结核患者痰检率、痰检阳性率、痰检合格率等,采用SPSS19.0统计软件进行统计,应用Cox-Stuart显著性检验进行变化趋势的统计学处理,分析疫情变化趋势及原因。结果 2004—2013年活动性肺结核患者登记率呈下降趋势,新涂阳患者登记率无升降趋势;新涂阳肺结核患者占活动性肺结核的比例范围为22.75%～37.00%,无升降趋势;各年新涂阳发现率无升降趋势。2011—2013年,活动性肺结核患者登记率年均下降3.7%,新涂阳患者登记率年均下降24.4%;新涂阳肺结核患者占活动性肺结核的比例范围年均递降21.58%;新涂阳发现率年均递降24.4%;新涂阳患者构成比年均递降1.3%,复治涂阳患者构成比年均递升13.9%。6县总痰检率为72.62%,痰涂片不合格率44.94%,初诊涂阳患者检出率为7.96%。结论 2004—2013年广西活动性肺结核疫情持续缓慢下降,但10年来新涂阳疫情依旧。2011年以来,新涂阳患者发现急剧下滑,下行压力加大,治疗管理质量滑坡。对结核病防控行政推动减弱,对痰涂片检查工作督查不力,是导致质量下降的主因。

Trend analysis of the pulmonary tuberculosis epidemic in Guangxi Zhuang autonomous region from 2002 to 2013

Objective To analyze the trend of the pulmonary tuberculosis epidemic in Guangxi from 2002 to 2013,and to evaluate the quality of the tuberculosis case detection. Methods Data from the Guangxi Tuberculosis Information Management System and the site supervision for the tuberculosis prevention in 6 counties including rongxian,xingye,fuchuan, zhaoping,cangwu,tengxian during 2002 to 2013 were used for analysis. The annual registration rate of active pulmonary tuberculosis（ AP）,new smear-positive pulmonary tuberculosis（ NSP） and the proportion of NSP in AP during the same period were calculated. We also calculated the annual registration rate of case detection. The rate of sputum examination, positive result in sputum examination and the qualified sputum examination in 6 counties were obtained from the onsite sampling inspection. All analyses were performed by SPSS19. 0 software. The trend and cause of the epidemic were analyzed by the Cox-stuart significance test. Results From 2004 to 2013,there was a declining trend in the registration rate of AP. Neither lifting nor declining trend was found in the registration rate of NSP. The proportion of NSP in AP which ranged from 22. 75% to 37. 00% and the annual rate of NSP detection had no trend. From 2011 to 2013,the registration rate of AP and NSP decreased by an average of 3. 7% and 24. 4% each year respectively. The proportion of NSP in AP had a decline with an average of 21. 58% annually. The detection rate and the constituent ratio of NSP had a decline with average annual decrease of 24. 4% and 1. 3% respectively. The constituent ratio of the smear-positive in retreatment cases had a rise with an average increase of 13. 9% annually. The rate of sputum examination and disqualified sputum smear are 72. 62% and 44. 94% respectively. The detection rate is 7. 96% among newly diagnosed smear-positive cases. Conclusion From 2004 to 2013,there was a continually slight decline in the epidemic situation of AP,while there was no trend in the situation of NSP during the p