摘要
目的分析2009—2018年广东省东莞市老年结核病患者发现延迟情况的特征,为完善老年结核病防控工作提供科学依据。方法从《中国疾病预防控制信息系统》的子系统《结核病管理信息系统》中收集2009—2018年东莞市1637例老年(年龄≥60岁)结核病患者的资料,包括性别、年龄、户籍、治疗分类、患者来源等。采用单因素和多因素logistic回归分析结核病患者就诊延迟和确诊延迟的影响因素。结果老年结核病患者的就诊延迟率为74.3%(1216/1637),确诊延迟率为13.5%(221/1637)。影响就诊延迟的多因素logistic回归分析表明,本地患者的就诊延迟率高于外地患者(OR=1.31,95%CI:1.04~1.66);以市区/中部/东北/西北片区为参照,西南片区患者的就诊延迟率较高(OR=1.49,95%CI:1.04~2.12),东南片区患者的就诊延迟率较低(OR=0.71,95%CI:0.50~0.99);病原学阳性及单纯结核性胸膜炎患者的就诊延迟率高于病原学阴性患者(OR=2.08,95%CI:1.61~2.70);2014—2018年患者的就诊延迟率高于2009—2013年患者(OR=1.63,95%CI:1.29~2.06);复治患者的就诊延迟率低于初治患者(OR=0.45,95%CI:0.29~0.70)。影响确诊延迟的多因素logistic回归分析表明,复治患者的确诊延迟率高于初治患者(OR=1.94,95%CI:1.09~3.47);因症就诊患者的确诊延迟率高于追踪和其他患者(OR=3.24,95%CI:1.49~7.05);病原学阳性及单纯结核性胸膜炎患者的确诊延迟率低于病原学阴性患者(OR=0.49,95%CI:0.34~0.69);2014—2018年患者的确诊延迟率低于2009—2013年患者(OR=0.50,95%CI:0.37~0.67)。结论东莞市老年结核病患者发现延迟情况仍然不容乐观,应继续针对老年人群开展有针对性的宣传教育。
Objective To analyze the characteristics of diagnosis delay among elderly tuberculosis patients in Dongguan City from 2009 to 2018,so as to provide scientific basis for improving the prevention and control of elderly tuberculosis.Methods Medical information regarding 1637 elderly tuberculosis patients from Dongguan was collected from the subsystem of China Information System for Disease Control and Prevention-Tuberculosis Information Management Systemfrom 2009 to 2018,which included gender,age,domicile place,treatment category,source of patient,etc.Univariate and multivariate logistic regression were used to analyze the influencing factors of patient delay and facility delay.Results The patient delay of elderly TB patients was 74.3%(1216/1637),and the facility delay was 13.5%(221/1637).The multivariate analyses of patient delay indicated that the patient delay rate of local patients was significantly higher than that in nonlocal patients(OR(95%CI):1.31(1.04-1.66)).Taking urban area/central area/northeast area/northwest area as reference,the patient delay rates were higher in patients in southwest area(OR(95%CI):1.49(1.04-2.12)),but lower in patients in southeast area(OR(95%CI):0.71(0.50-0.99)).The patient delay rate in patients with positive etiology and only tuberculosis pleurisy was significantly higher than that in patients with negative etiology(OR(95%CI):2.08(1.61-2.70)).The patient delay rate in patients from 2014 to 2018 was significantly higher than that from 2009 to 2013(OR(95%CI):1.63(1.29-2.06)).The patient delay rate in retreatment patients was lower than that in new patients(OR(95%CI):0.45(0.29-0.70)).The multivariate analyses of facility delay indicated that the rate of facility delay was higher in retreatment patients than in new patients(OR(95%CI):1.94(1.09-3.47)),was higher in patients with clinical consultation than that in tracing and other patients(OR(95%CI):3.24(1.49-7.05)),was lower in patients with positive etiology and only tuberculosis pleurisy than that in patients with negative etiology
作者
关福源
陈智昊
李文辉
叶小华
钟新光
GUAN Fu-yuan;CHEN Zhi-hao;LI Wen-hui;YE Xiao-hua;ZHONG Xin-guang(Department of Prevention and Health Care,the Sixth People’s Hospital of Dongguan,Dongguan 523008,China;Department of Epidemiology and Health Statistics,School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China)
出处
《结核与肺部疾病杂志》
2021年第3期243-250,共8页
Journal of Tuberculosis and Lung Disease
基金
国家自然科学基金(81973069)
广东省自然科学基金(2019A1515010915)。
关键词
结核
老年人
就诊延迟
确诊延迟
因素分析
统计学
Tuberculosis
Aged
Patient delay
Facility delay
Factor analysis,statistical
