| Objective1.To analyze the epidemiological characteristics of pulmonary tuberculosis in Yixing City from 2008 to 2015,and to explore the prevalence of registered pulmonary tuberculosis2.Understand the management status and existing problems of pulmonary tuberculosis in Yixing City,corresponding prevention and control strategies is proposedMethodThis was retrospective,descriptive study based on the PTB surveillance data in Yixing city from January 2008 to December 2015,which were extaacted from the TB Information Management System.The data was entered into Epidata3.1 database,and statistical analysis was performed using SPSS18.0.The distribution difference was analyzed by chi-square test and single factor logistic regression.There was statistical difference in P value less than 0.05.Results1.Overall,there were 3317 cases of registered pulmonary tuberculosis patients in Yixing City during 2008 to 2015,with 27.69 per 100000-39.74 per 100000 of incidence of registration rate,and the average was 33.12 per 100000;with 25.13 per 100000 to 37.60 per 100000 of incidence of r smear-positive recently newly registered rate,and the average was 31.01 per 100000;with 7.66 per 100000-28.46 per 100000 of incidence of recently newly smear-positive registered rate,and the average was 16.44 per 100000.and showed a declining trend as the years.2.There were 2480 males cases,which accounting for 74.77%,the ratio between male and female was 2.96,which had a significant difference(?2=13.87,P=0.053);the male registration rate in the household registration population was 33.01 per 100000 to 45.97 per 100000,and the average was 39.37 per 100,000,the female registration rate was 11.39 per 100000-15.84 per 100,000,and the average was 13.76 per 100,000.Compared with the sex ratio registration rate,men are higher than women,which had a significant difference(?2=533.42,P<0.001);Registered PTB patients aged 15 to 44 took the highest proportion,reaching 50.02%,and the 0 to 14 age group accounted for the least(0.90%),there was no statistical difference in the distribution of all age groups(?2=30.52,P=0.082);there were 1571 farmers,accounting for the highest proportion(47.36%),and there was no statistical difference in occupational distribution(?2=6.642,P=0.467);there were local 2,222 local patients,accounting for 66.99%;the local of registration rate was 25.81 per 100,000,and the floating was 77.91 per 100,000,which had a significant difference(?2=990.43,P<0.001);among the floating population of pulmonary tuberculosis patients registered in 2009-2015,217 cases of household registration in Guizhou,accounting for the highest proportion(23.69%);Spring and summer registration is slightly higher than autumn and winter.3.The ratio of initial treatment and retreatment was 9.84-50.13,and the average ratio was 14.65,which had a significant difference(?2=30.43,P<0.001);the ratio of smear positive to smear negative was 0.50-4.38,and the average ratio was 1.16,which had a significant difference(? =519.88,P<0.001).there were 208 new smear-positive cases of drug-susceptible suspicious recruited during 2012 to 2015,accounted for the highest proportion(67.75%),Among the suspicious individuals,including 11 cases of multidrug-resistant patients,1 case of extensive drug resistance,and 1 case of single drug resistance;49.08%of patients were from referral,followed by symptomatic treatment,there was a statistically significant difference in the source distribution of patients(?2=635.18,P<0.001);19.05%of patients had cavitations,and there was statistical difference in the cavitations distribution(?=55.02,P<0.001).4.A total treatment success rate was 89.40%-95.76%,the average was 92.34%,which had a significant difference(?2=510.60,P<0.001);Multidrug-resistant patients had an upward trend in recent years,while the rate of defaulters and others showed downward trend as the years;the 8-year average treatment success rate of new cases and retreatment cases were 92.66%and 83.49%,respectively,and the former had a significant difference(?2=27.66,P=0.000),while the latter had no significant difference(?2=9.47,P=0.22);the average treatment success rate of smear-positive patients was 89.17%,which had had a significant difference(?2=16.67,P=0.022),but it showed a downward trend;the average treatment success rate of smear-negative pulmonary tuberculosis patients was 95.50%,which had no significant difference(?2=9.73,P=0.204).5.The median delay was 13 days in hospital visit,and the median delayed diagnosis time was 3 days.There were no significant difference about gender,age,household registration,patient source,patient classification in hospital visit delay(P>0.05),and there were significant differences about occupational factors in hospital visit delay(P<0.05);There were no significant difference about occupational factors,patient source,patient classification in diagnosis delay(P>0.05).and there were significant differences about gender,age,household registration in diagnosis delay(P<0.05).Conclusions1.The registration rate of PTB,new patients and smear patient all decreased year by year in Yixing City indicating that the current prevention mode and DOTS strategy of pulmonary tuberculosis have achieved good results.2.The current problems of Yixing city were such as imperfect medical cooperation mechanism was not perfect,insufficient work guarantee funds,and the progress of the multi-drug resistance was slow,and MDR patients are not included in the single-species fixed-rate payment guarantee policy.The next step is to continue to improve the service system,implement funding guarantees,Screening of high-risk groups for multi-drug resistance should be implemented,attache great importance to the inclusion of treatment and follow-up management for MDR,improve the incidence rate of pulmonary tuberculosis patients,increase the awareness of prevention and treatment of them.3.The discovery and management of patients should pay great attention to young adults and physical labor people.4.It is important and difficult for PTB control to improve the treatment success rate for smear patients.5.Discovery delay of pulmonary tuberculosis patients and compliance with treatment could improve the success rate of PTB treatment. |
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