Epidemiological Characteristics Of Tuberculosis And Analysis Of Diagnosis And Treatment Of Drug-resistant Tuberculosis In Guizhou Province During 2013 To 2018

Objective:To analyze the epidemiological characteristics of common tuberculosis(TB)and drug-resistant tuberculosis(DR-TB)in Guizhou Province from 2013 to 2018,and explore the diagnosis and treatment of DR-TB,so as to provide evidence for the prevention and control of key populations.Methods:Data from the Chinese information system of disease prevention and control tuberculosis registration information management system of 2013-2018 in Guizhou province of TB and DR-TB patient’s medical record information and field investigation results,Descriptive statistical methods were used to investigate and analyze the gender,age,occupation and regional differences of TB and DR-TB patients in Guizhou Province from 2013 to 2018,and trend chi-square test was used to analyze the change trend of incidence and constituent ratio.The distribution characteristics of DR-TB were also analyzed by Fisher exact test.Results:From 2013 to 2018,the reported incidence of Guizhou province decreased from134.28/10lakh to 114.06/10lakh(trendc~2=630.966 p<0.001).The incidence ratio of male and female was 1.88:1,and there was no statistically significant difference in the change of gender composition ratio(trendc~2=2.483 p=0.115).The occupations with increasing incidence and composition ratio of tuberculosis were students(trendc~2=1092.775 P<0.001),housework and unemployment(trendc~2=338.114P<0.00),cadres and workers(trendc~2=19.415 P<0.001),and business services(trendc~2=6.633 P=0.009).The age composition of the incidence of tuberculosis showed an increasing trend among the patients aged 15-24(trendc~2=215.931P<0.001),50-54(trendc~2=487.589 P<0.001)and 65-79(trendc~2=40.325P<0.001).The areas composition of the incidence of tuberculosis showed an increasing trend were Liupanshui city(trendc~2=4.566 P=0.033),Anshun city(trendc~2=27.579 P<0.001)and Bijie city(trendc~2=81.055 P<0.001).The number of DR-TB cases in Guizhou province increased from 39 cases in 2013 to 225 cases in2018,with a total of 966 cases,including 671 males and 295 females.The sex ratio of male to female was 2.27:1.The majority of patients were aged from 21 to 40 years old(405 cases,41.93%),whose composition ratio showed a significant decreasing trend(trendc~2=6.126,P<0.05).The most patients were farmers(482 cases,49.90%),and the student patient ratio showed a significant increasing trend(trendc~2=7.052,P<0.01).Bijie had the most DR-TB patients(226 cases,23.40%).The largest number of patients were registered with initial treatment failure(464 cases,48.03%),and the composition ratio of new patients showed a significant upward trend(trendc~2=30.543,P<0.01).In the detection of drug resistance,molecular biological detection was60.14%,and the composition ratio showed a significant increasing trend(trendc~2=111.547,P<0.01).97(10.04%)of the patients had previously used second-line anti-TB drugs before receiving DR-TB treatment.MDR-TB(847cases,87.68%)was the most resistant,followed by rifampicin resistance(RR-TB).From2013 to 2016,there were 186 cases diagnosed as cure and 94 cases diagnosed as completion of the two-year treatment course,there was a significant decreasing trend in patients treated each year(trendc~2=8.797,P<0.01),and the successful treatment rate of MDR/RR-TB was 54.25%,showing a significant increase(trendc~2=8.573,P<0.01).Conclusion:In nearly six years,Guizhou TB epidemic overall decline is obvious,but some occupations,ages and areas need to be noticed.Take the initiative to screen the key population and find the patients,so as to move the detection threshold forward,so as to achieve early detection,early diagnosis and early treatment,appropriately step up active screening of business services,cadres and workers,and people aged 65 to 79,and formulate and implement policies on health examinations.Continue to strengthen the physical examination of freshmen and the screening of students’close contacts of TB patients.The DR-TB patients in Guizhou province show an increasing trend mainly of MDR-TB,so it is necessary to strengthen the monitoring of tuberculosis resistance,especially the monitoring of primary drug resistance of patients initially treated.It is suggested to improve the inclusion and successful treatment rate of drug-resistant patients by increasing the reimbursement rate of patients‘medical expenses.