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《2010年结核病年度报告——(5)病例发现》

[Tuberculosis annual report 2010--(5) Case finding].

出版信息

Kekkaku. 2012 Oct;87(10):681-5.

Abstract

We reviewed the tuberculosis (TB) surveillance database to determine the mode of detection, delays in achieving a TB diagnosis, and patients' occupational status upon registration. Of the 23,261 TB patients who were newly notified in 2010, 81.7% were diagnosed at medical institutions. Of these, 12.0% were diagnosed during hospitalisation with a disease other than TB, and 9.9% were diagnosed during outpatient visits with diseases other than TB. The overall proportion of TB cases detected by contact examination was only 2.8%, but this mode of detection was higher (56.1%) among younger TB patients aged 0-14 years. Of the 18,328 pulmonary TB patients, 27.3% had only respiratory symptoms, 31.0% had both respiratory and other symptoms, and 16.4% had only non-respiratory symptoms. Approximately one-quarter of elderly patients aged > or = 80 years with symptomatic pulmonary TB had only non-respiratory symptoms. pulmonary TB tended to have long total delays (the amount of time between the onset of symptoms and diagnosis). Among elderly patients, patient delays tended to be short, whereas doctor delays tended to be long. Of the 2,785 female pulmonary TB patients aged 20-59 years, 14.5% were medical workers and 10.4% of these were nurses.

摘要

我们查阅了结核病监测数据库,以确定检测方式、结核病诊断延迟情况以及患者登记时的职业状况。在2010年新报告的23261例结核病患者中,81.7%在医疗机构被诊断。其中,12.0%是在因其他疾病住院期间被诊断为结核病,9.9%是在因其他疾病门诊就诊时被诊断为结核病。通过接触者检查发现的结核病病例总体比例仅为2.8%,但在0至14岁的年轻结核病患者中,这种检测方式的比例较高(56.1%)。在18328例肺结核患者中,27.3%仅有呼吸道症状,31.0%有呼吸道和其他症状,16.4%仅有非呼吸道症状。年龄≥80岁有症状的肺结核老年患者中,约四分之一仅有非呼吸道症状。肺结核往往有较长的总延迟时间(从症状出现到诊断的时间)。在老年患者中,患者延迟往往较短,而医生延迟往往较长。在2785例年龄在20至59岁的女性肺结核患者中,14.5%是医务人员,其中10.4%是护士。

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