| Objective:In order to have a good master of the epidemic outbreak as well as the management of current pulmonary tuberculosis in Pudong New Area, Pudong Center for Disease Prevention and Control has collected the epidemic information of all tuberculosis cases from the year 2000 to 2008 and conducted an elementary epidemiological analysis of pulmonary tuberculosis cases in Pudong New Area with the aim of offering scientific evidence to local health authorities for the establishment of future anti-tuberculosis strategy.Methods:We have analyzed all registered patients of pulmonary tuberculosis who have been diagnosed during the period from January 1st,2000 to December thirty-first,2008. All necessary information of these patients have been collected including name,age,occupation,method of diagnosis,type of tuberculosis,early symptoms,date of seeking medical advice,date of diagnosis,first treatment scheme, etc. The data of demography including characteristics of patients'age and sex during the same period (January 1st,2000 to December thirty-first,2008) was offered by Demographic information department of Pudong Center for Disease Prevention and Control.In the process of analysis, we have employed many methods of statistics such as total annual incidence of tuberculosis,incidence of two sexes,incidence of different age group.The disparity of incidence between different years and sexes were compared by the method of Chi-Square Test or U Test. Quantitative data were compared by the method of Rank Sum Test.Results:1. During the period from the year 2000 to 2008, there were 4,892 cases of tuberculosis in total in Pudong New Area. The incidence of tuberculosis was fluctuated at 30/100,000. Through serious analysis, we discovered that the incidence of tuberculosis in the past nine years has gradually dropped.2. The incidence of male population was nearly three times higher than that of female population. Surprisingly, the incidence of tuberculosis was sharply increased among the population who is sixty years or older. We even found that the incidence of tuberculosis could be higher than 100/100,000 in several age group.3. New cases of pulmonary tuberculosis in Pudong New Area were mainly workers,retirees,retired veteran cadres and housewives who accounted for about 67.8% of all tuberculosis patients.4. According to the data of registered cases,91% of tuberculosis cases were detected in hospital since they felt discomfort. About 9% patients were discovered by general physical examination. Among all tuberculosis patients, over 80% were newly-infected cases.5. In the year 2000,18.3% of tuberculosis patients have contracted pulmonary cavities. While in the year 2008, the ratio of tuberculosis patients contracting pulmonary cavities were increased to 25.9%. Thus, we have reached the conclusion that tuberculosis patients with pulmonary cavity are gradually increasing.6. In terms of types of pulmonary tuberculosis, a vast majority of tuberculosis cases were infiltrated type.7. Results of sputum test showed that the positive rate of sputum test from the year 2000 to 2008 were 36.0%,39.1%,43.8%,41.3%,39.0%,42.2%,41.8%,46.6% and 45.2% respectively. The average positive rate of sputum test in the nine years was 41.7%.8. About 40%-50% of pulmonary tuberculosis patients were hospitalized. In addition to hospitalization, other methods of treatment include whole course management of tuberculosis and DOTS. Before the year 2004, whole course management of tuberculosis was preferred while more than 50% tuberculosis patients have accepted the treatment of DOTS the year after 2004.9. At present, there are two major methods of treatment:tubercle bacillus positive 2S(E)HRZ/4HR (40.8%) and tubercle bacillus negative 2S(E)HRZ/3HR (38.4%).10. The total reported number of non-resident pulmonary tuberculosis during the period of 2002-2008 is 3863 cases. The new average reported incidence is 60.45/100.000 with the highest incidence rate of 2003 which is 1.55 times than that of 2007. The new sputum positive rate of 2004 was increased rapidly, reaching 16.90/100.000. Although the new reported incidence of the year 2006 and 2007 is deceased, the percentage of sputum positive patients is increased.11. The incidence rate of male non-resident is obviously higher than that of female non-resident with the ratio of 2 between male and female.12. The non-resident cases of pulmonary tuberculosis come from Anhui, Sichuan and Jiangsu Provinces which account for 50% of the total.Conclusion:1. At present, pulmonary tuberculosis in Pudong New Area has the following characteristics:the incidence of male population is higher than that of female population; the incidence of old patients is higher than that of middle-aged and young patients; the vast majority of tuberculosis cases are middle-aged and old people; most new cases of tuberculosis are tested positive in sputum examination; workers,retirees. retired veteran cadres and housewives are frequently subjected to pulmonary tuberculosis; The general incidence of tuberculosis in Pudong New Area is fluctuated at 30/100,000. All these information showed that Pudong New Area is still plagued by serious pulmonary tuberculosis. Therefore, we will continue to strengthen the management of tuberculosis cases in future anti-tuberculosis efforts.2. The detective rate of pulmonary tuberculosis is low. Because some 9% of tuberculosis cases were detected by way of general physical examination, we should offer better service of physical examination for middle-aged and old people so that suspected cases could be diagnosed and treated at an early period.3. On the basis of hospitalization, we should continue to promote the change of whole course of management to household management method so that every patient could receive whole standard treatment even at home or local community.4. It is necessary to promote the health propaganda campaign and management of pulmonary tuberculosis for non-resident cases which is important to the control of pulmonary tuberculosis in Pudong New Area. |
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