2015—2021年重庆市肺结核患者发现延误及影响因素分析

目的:分析2015—2021年重庆市肺结核患者发现延误情况及影响因素,为减少患者发现延误提供科学依据。方法:从“中国疾病预防控制信息系统”子系统“传染病报告信息管理系统”收集2015—2021年重庆市肺结核患者相关信息,包括报告时间、患者的人口学特征(性别、年龄、职业)、地区、患者来源、疾病诊断、发病日期和诊断日期,共获得174 067例患者信息。2015—2021年肺结核患者发现延误率的变化采用Joinpoint回归模型进行趋势分析,采用多因素logistic回归分析发现延误的影响因素。结果:2015—2021年重庆市肺结核患者发现延误时间中位数为31(10,73) d,年均发现延误率为53.25%(92 695/174 067);由2015年的58.20%(15 093/25 935),下降至2021年的50.18%(11 026/21 974)。2015—2021年发现延误率总体呈下降趋势(AAPC=-2.5%,t=-2.095,P=0.036),2015—2019年发现延误率下降趋势差异有统计学意义(APC=-4.1%,t=-4.313,P=0.049),2019—2021年发...     

2012-2014年重庆市结核分枝杆菌 和人类免疫缺陷病毒感染双向筛查情况分析

摘要:目的　分析重庆市结核分枝杆菌（Mtb）和人类免疫缺陷病毒（HIV）感染双向筛查情况,为Mtb/HIV双重感染（简称“双感”）防治工作提供科学依据和改进建议。方法　整理2012-2014年重庆市39个区县级结核病防治机构的双重感染防治管理工作年度报表资料,使用卡方检验对HIV感染者和艾滋病（AIDS）患者的结核病（TB）筛查率、TB检出率、TB患者的HIV抗体检测率和HIV抗体阳性检出率的年度变化趋势进行分析。结果　（1）2012-2014年重庆市HIV/AIDS人群的TB筛查率呈显著上升趋势（χ2趋势＝444.035,P＜0.01）。TB检出率呈显著下降趋势（χ2趋势＝19.185,P＜0.01）。（2）TB患者接受HIV抗体检测率呈上升趋势（χ2趋势＝161.399,P＜0.01）,HIV阳性检出率未见显著变化（χ2趋势＝0.041,P＝0.839）。结论　Mtb/HIV双向筛查是发现TB/HIV双感患者的有效途径。因此,积极开展有针对性的Mtb/HIV双向筛查工作,提高双感患者发现率和治愈率,才能有效控制TB/HIV双感疫情。     

2011—2020年重庆市结核病防治经费投入与效益产出分析

目的 评估重庆市2011—2020年结核病防治经费投入产生的社会效益。方法 收集《传染病监测系统》中2011—2020年重庆市登记涂阳肺结核患者（初治涂阳和复治涂阳）治疗转归情况和肺结核患者劳动人口比例,历年各级政府结核病防治经费投入,历年全市人均国内生产总值（gross domestic product,GDP）等数据,采用常用卫生经济学方法评估10年间结核病防治经费投入的社会效果、社会效用和社会效益。结果 2011—2020年,全市共投入结核病防治经费约3.60亿元,成功治疗涂阳肺结核患者60 924例,避免45.69万名健康人受传染,挽救43.41万个伤残调整生命年（disability adjusted life year,DALY）,为社会节约医疗费用3.26亿元,挽回社会经济损失约176.25亿。保持目前的设施设备和人员条件不变,每投入787.70元即可避免1名健康人被传染,每投入829.16元即可挽救1个DALY,每额外投入1元即可产生49.87元的经济效益。结论 10年间重庆市结核病防治经费投入产生了较大的卫生经济效益,建议各级政府继续加大结核病防治经费投入。     

“十三五”期间重庆市涪陵区肺结核时空分布特征

目的 分析“十三五”期间重庆市涪陵区活动性肺结核和病原学阳性肺结核的时空分布特征，探索聚集区域，为涪陵区结核病精准防控提供科学依据。方法 收集2016—2020年重庆市涪陵区27个镇街的肺结核患者登记资料，采用描述性流行病学方法对患者的时间和空间分布特征进行描述，SaTScan9.0进行时空扫描分析，ArcGis10.6进行全局和局部自相关分析，并对结果可视化。结果 “十三五”期间涪陵区肺结核患者累计登记4 038例，登记率总体呈下降趋势，年均登记率70.17/10万，年均递降率8.21%。活动性肺结核患者累计登记高峰在3月份，病原学阳性肺结核患者在6月份；活动性肺结核患者累计登记数排在前5位的分别为荔枝街道、敦仁街道、崇义街道、马鞍街道、江东街道，合计占“十三五”期间累计登记患者数的比例为60.18%，年均登记率排在前3位的分别为敦仁街道（101.35/10万）、崇义街道（101.34/10万）、武陵山乡（99.21/10万）。2016—2020年登记的肺结核整体上呈全局自相关性（Moran’s I值为0.64,P<0.000 1），活动性肺结核和病原学阳性肺结核“高-高”聚集...     

2007年重庆市云阳县和璧山县8～10岁儿童尿碘水平分析

目的 了解重庆市抽样地区人群尿碘水平,探讨其影响因素.方法 选择重庆市渝东地区的云阳县和渝西地区的璧山县为调查县,采用多级整群随机抽样方法,在两县经济状况为中等的一类乡镇中,各抽取3所乡镇小学,在每所小学选择8～10岁儿童30名作为调查对象,检测其尿碘、家庭食用盐含碘量,采集当地居民饮用水水样,检测含碘量.结果 共检测儿童尿样571份,云阳县和璧山县总的尿碘中位数为261.47μg/L,尿碘<100μg/L和>300μg/L的比例分别为5.78%(33/571)和37.48%(214/571);云阳县儿童尿碘中位数(278.64μg/L)高于璧山县(240.6μg/L),二者比较差异有统计学意义(H=7.42,P<0.01).检测家庭食用盐556份,碘盐覆盖率、碘盐合格率、合格碘盐食用率分别为99.64%(554/556)、94.22%(522/554)、93.88%(522/556).检测居民饮用水87份,两县水碘均值分别为8.81、2.97μg/L.结论 云阳县、璧山县均为缺碘地区,人群尿碘水平达到消除碘缺乏病的标准.但在长期食用现行加碘量食盐的情况下,调查地区儿童尿碘水平有偏高的趋势,可考虑适当调整食盐含碘量.     

碘盐防治碘缺乏病效果的系统评价

目的 评价不同含碘量食盐防治碘缺乏病的效果.方法 采用Cochrane系统评价的原理与方法,通过计算机检索的Cochrane Library(1994-)、Medline光盘数据库(1966-)、BA数据库(1969-)、PubMed(1950-)、OVID数据库(1950-)、ISI Web of Knowledge(1966-)、维普中文科技期刊数据库(1989-)、万方数据库(1997-)、中国生物医学文献光盘数据库(1978-)、CNKI(1994-),并手工检索<中华预防医学杂志>(1953-)、<中国地方病学杂志>(1986-)、<中华流行病学杂志>(1981-)、<中国地方病防治杂志>(1986-)、<地方病通报>(1986-)、<现代预防医学>(1975-)6种杂志,时间均截止到2007年3月.按照纳入、排除标准纳入合格的有效文献,并对其进行严格的质量评价,对结果 进行描述性分析及定性综合.结果 共纳人13项观察.前6项观察为设有对照的干预试验,其中2项为社区干预试验,采用不同含碘量的食盐对人群实施干预:4项为随机对照试验,比较碘盐和其他干预措施对碘缺乏病的防治效果.另外7项为横断面调查,分析盐含碘量下调后,人群碘营养状况.经过分析显示,食用低碘盐的人群尿碘水平较为合理,甲状腺肿大率也明显下降.结论 碘盐被认为是预防碘缺乏病最好的补碘方法,但不同含碘量食盐对碘缺乏病的防治效果有不同.适当的降低盐含碘量不仅能达到防治碘缺乏病的目的,而且能使由于碘摄入过量导致的副作用降到最低,同时可以节约大量的碘资源.目前,尚需要开展高质量、大样本的社区干预试验,以深入探讨不同加碘量的食盐对碘缺乏病的防治效果.     

2007年重庆市云阳县和璧山县8～10岁儿童尿碘水平分析

Objective To determine the urinary iodine level of people in Yunyang and Bishan County of Chongqing and explore into its influencing factors. Methods Using multistage cluster stratified simple random sample method, Yunyang and Bishan County were chosen as research spots, then thirty children aged 8-10 in each 3 primary school of the 2 counties were selected using stratified randomization sampling method to inspected their urine and household salt for iodine and the iodine content in drinking water. Results Five hundred and seventy-one urine samples were inspected and the urinary iodine median was 261.47 μg/L. 5.78% (33/571) and 37.48%(214/571) of samples had an urinary iodine median less than 100 μg/L and more than 300 μg/L. The urinary iodine median of Yunyang County was higher than that of Bishan (H = 7.42, P < 0.01). The iodine salt coverage rate, the qualified rate and edible qualified iodine salt rate respectively were 99.64%(554/556), 94.22% (522/554) and 93.88% (522/556) in 556 samples of family table salt. Eighty-seven samples of drinking water were inspected, resulting an averaged iodine content of 8.81 and 2.97 μg/L, respectively in the 2 counties. Conclusions The 2 counties are all the area of iodine deficiency. The urinary iodine level, although meeting the demand of eliminating iodine deficiency diseases, is a little bit higher given that iodized salt of present doage has been taken for a long time. The content of iodized salt should be adjusted accordingly.     

2007年重庆市云阳县和璧山县8～10岁儿童尿碘水平分析

Objective To determine the urinary iodine level of people in Yunyang and Bishan County of Chongqing and explore into its influencing factors. Methods Using multistage cluster stratified simple random sample method, Yunyang and Bishan County were chosen as research spots, then thirty children aged 8-10 in each 3 primary school of the 2 counties were selected using stratified randomization sampling method to inspected their urine and household salt for iodine and the iodine content in drinking water. Results Five hundred and seventy-one urine samples were inspected and the urinary iodine median was 261.47 μg/L. 5.78% (33/571) and 37.48%(214/571) of samples had an urinary iodine median less than 100 μg/L and more than 300 μg/L. The urinary iodine median of Yunyang County was higher than that of Bishan (H = 7.42, P < 0.01). The iodine salt coverage rate, the qualified rate and edible qualified iodine salt rate respectively were 99.64%(554/556), 94.22% (522/554) and 93.88% (522/556) in 556 samples of family table salt. Eighty-seven samples of drinking water were inspected, resulting an averaged iodine content of 8.81 and 2.97 μg/L, respectively in the 2 counties. Conclusions The 2 counties are all the area of iodine deficiency. The urinary iodine level, although meeting the demand of eliminating iodine deficiency diseases, is a little bit higher given that iodized salt of present doage has been taken for a long time. The content of iodized salt should be adjusted accordingly.     

2007年重庆市云阳县和璧山县8～10岁儿童尿碘水平分析

Objective To determine the urinary iodine level of people in Yunyang and Bishan County of Chongqing and explore into its influencing factors. Methods Using multistage cluster stratified simple random sample method, Yunyang and Bishan County were chosen as research spots, then thirty children aged 8-10 in each 3 primary school of the 2 counties were selected using stratified randomization sampling method to inspected their urine and household salt for iodine and the iodine content in drinking water. Results Five hundred and seventy-one urine samples were inspected and the urinary iodine median was 261.47 μg/L. 5.78% (33/571) and 37.48%(214/571) of samples had an urinary iodine median less than 100 μg/L and more than 300 μg/L. The urinary iodine median of Yunyang County was higher than that of Bishan (H = 7.42, P < 0.01). The iodine salt coverage rate, the qualified rate and edible qualified iodine salt rate respectively were 99.64%(554/556), 94.22% (522/554) and 93.88% (522/556) in 556 samples of family table salt. Eighty-seven samples of drinking water were inspected, resulting an averaged iodine content of 8.81 and 2.97 μg/L, respectively in the 2 counties. Conclusions The 2 counties are all the area of iodine deficiency. The urinary iodine level, although meeting the demand of eliminating iodine deficiency diseases, is a little bit higher given that iodized salt of present doage has been taken for a long time. The content of iodized salt should be adjusted accordingly.     

重庆市两县小学生及家长碘缺乏病知识现况调查

目的了解重庆市两县小学生和家长防治碘缺乏病知识、态度、行为的现状。方法选择重庆市渝东地区的云阳县和渝西地区的璧山县为调查县,采用整群随机抽样方法,在每个县经济状况中等的一类乡镇中,各抽取3个乡镇小学,对各校五年级学生以及家长进行防治碘缺乏病知、信、行（KAP）问卷调查。结果共回收小学生问卷193份,家长问卷549份。对于碘缺乏病相关知识的回答,两县家长普遍认识程度不足30%,碘缺乏病防治知识知晓率有三题存在统计学差异;两地小学生的认识程度相似,约在50%左右,无统计学差异。对于行为相关知识知晓率,两地家长3个问题间均存在统计学差异。学生仅有一个问题存在统计学差异。结论本次调查的目标人群对碘缺乏病认识不足,碘缺乏病知识较为贫乏,学校应加强碘缺乏病知识健康教育,发挥学生对相关健康知识的传播作用,提高家长对碘缺乏病认知水平。