全国初治涂阴肺结核病例登记现状分析

目的分析全国各省初治涂阴肺结核病例登记现状,为评价初治涂阴肺结核病例诊断质量提供依据。方法根据2004—2005年全国结核病防治规划报表中初治涂阴和初治涂阳肺结核病例登记资料,分析各省2年初治涂阴肺结核病例登记率变化和增长幅度;统计各省及不同地区初治涂阴与初治涂阳肺结核病例登记率;对各省初治涂阴与初治涂阳肺结核病例登记率进行直线回归分析。结果2005年全国登记初治涂阴肺结核病例316 405例,登记率为24.27/10万,各省登记率在6.01/10万72.17/10万;2005年登记初治涂阴病例数比2004年增加了19.9%,其中2个省登记数呈负增长,其余各省登记数增长了0.5%62.3%;2005年全国初治涂阳病例登记率是涂阴病例登记率的1.5倍,其中23个省初治涂阳病例登记率高于涂阴病例登记率,8个省相反;初治涂阴病例占初治涂阳病人登记率的比例,京津沪地区为149.28%,非项目地区为83.6%,项目地区为50.3%;对涂阳和涂阴病例登记率进行直线回归分析,回归方程y=22.342+0.563 6x。结论对初治涂阴肺结核患者实行免费政策后,全国涂阴肺结核病例登记率提高。但各省初治涂阴病例登记率和增长幅度以及涂阴病例登记率与涂阳病例登记率的比例悬殊。由于涂阴病例诊断困难,对于涂阴病例登记率高或增长幅度大的地区,特别在DOTS执行时间短和人力资源有限的地区,应对涂阴病例诊断质量予以进一步检查和评价。

Analysis of the situation of register on the nationwide smear-negative pulmonary tuberculosis cases

Objective To analyze the situation of register on the nationwide smear-negative pulmonary tuberculosis(PTB) cases,to provide relevant evidence in order to evaluate the quality of diagnosis on initial smear-negative TB cases. Methods According to data from register of initial smear-negative PTB and initial smear-positive PTB from report forms of the National TB Control Programme(NTP) from 2004 to 2005,the change of the notification rate on initial smear-negative PTB cases and its increased range of the every province during the two years were analyzed;proportion of the notification rate of smear-negative TB cases and smear-positive TB cases among every province and different area were calculated;linear regression analysis was done for the notification rate of both smear-negative and smear-positive TB. Results The number of registered initial smear-negative TB case in the country in 2005 was 316 405 with the notification rate of 24.27/100 000,rang of the notification rate of different provinces was 6.01/100 000～72.17/100 000.The number of notified smear-negative TB cases increased 19.9% compared to 2004 among which two provinces decreased compared to 2004,while the number in other provinces increased between the range of 0.5%～62.3%;the notification rate of initial smear-positive TB was as 1.5 times as that of smear-negative TB,among which notification rate of smear-positive TB was higher than that of smear-negative TB in 22 provinces and lower in 8 provinces;the proportion of the notification of initial smear negative TB to initial smear positive TB was 149.28% in Beijing,Tainjin and Shanghai,83.6% in non-project area and 50.3% in project area.Linear regression analysis on notification rate of smear-negative TB and smear-positive TB was done and the linear regression equation was Y= 22.342+0.563 6 x. Conclusion The notification rate of smear-negative TB has increased after the policy of providing free treatment to initial smear negative TB was implementing.However,the notification of smear-negative TB,its incremental range and the proportion of the notification of smear negative TB to smear positive TB are substantially different among provinces.Due to the difficulty in diagnosis of smear-negative cases,it is necessary to examine and evaluate the quality on the diagnosis of smear-negative cases in the areas of higher notification or substantial incremental range,especially in the areas where DTOS have carried out for short period of time and with limited human resource.