| Objective:To understand the status of case detection and treatment management on tuberculosis(TB)patients in Yecheng,kashgar,Xinjiang province,and investigating their influencing factors.In order to provide advice to further improve TB control work.Methods:In this study,12 townships with DR equipment in yecheng were screened for tuberculosis among the aged 65 and above.Elderly tuberculosis patients were divided into three categories according to the screening results,they are newly discovered patients,known patients under treatment and known patients not under treatment.Different types of TB questionnaires were given to different patients,including general information,health education status,morbidity and treatment status before this survey and overall treatment status.Descriptive statistics,t test,?~2 test and multivariate logistic regression were used.Results:1)A total of 13,125 elderly people were screened,206 of them are han(1.57%).The testing rate was 98.6%.1413 tuberculosis patients were detected,1,393(98.58%)were Uygur,the average detection rate was 10765.71/100,000.1,097 were newly treated,316 were retreated.1,397 were sputum smear negative and 16 were sputum smear positive.Among them,1,104(78.13%)patients were newly identified,128(9.06%)were known to be under treatment and 38(2.69%)were known to be untreated.2)In newly identified patients,the male to female ratio was 1.7:1.The detection rate was 8411.4/100,000,and it increased with the increase of age.92.2%of patients received TB education,mainly from doctors,797(72.2%)subjects had tuberculosis symptoms,55.1%of the symptomatic patients visited the doctor,all were diagnosed with other diseases.The main reasons for not seeking medical treatment were light self-symptom and economic difficulty.95.23%of symptomatic patients occurred delayed detection,personal annual net income(OR=3.51,95%CI=1.109-11.096,P=0.033),family annual net income(OR=0.12,95%CI=0.033-0.417,P=0.010)were the influencing factors for delayed detection.The factors that influence the findings are age(OR=0.97,95%CI=0.939-0.993,P=0.014),family size(OR=1.08,95%CI=1.019-1.142,P=0.009),personal annual net income(OR=0.55,95%CI=0.359-0.855,P=0.008);3)Among the known patients,the treatment rate was 77.11%.All received health education,mainly for doctors.(1)Among the treated patients,four of them(4/128)received intermittent treatment due to going out,improved condition and ineffective treatment,while the rest received standardized treatment.(2)Among the known untreated patients.One had never received treatment due to family difficulties,The rest were discontinued because of obvious improvement of symptoms,going out,adverse drug reactions and other complications.The mean duration of antituberculosis treatment was 80.9 days.The delay rate was 50.0%,the mean time between symptomatic visits was 133.2 days.Diagnosis delayed rate was 34.4%,with an average interval of 250.2 days between first visit and diagnosis.Personal annual net income(OR=17.6,95%CI=1.155-28.046,P=0.039)was influencing factors for delayed treatment.No significant variables were found for the delay in diagnosis.In addition,no factors were found that affected the treatment of known patients.Conclusions:1)The TB situation in this region is serious,and the health sector should increase investment in TB control in this region;2)The knowledge of TB related knowledge of the elderly population in this area is not enough,and the TB health education work should be further improved;3)It is necessary to improve the diagnosis and treatment technology of grassroots health workers,and improve the equipment and patient management system. |
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