Girard D, Antoine D, Che D
Institut de veille sanitaire, 12, rue du Val-d’Osne, 94415 Saint Maurice cedex, France
Med Mal Infect. 2014 Dec;44(11-12):509-14. doi: 10.1016/j.medmal.2014.10.002.
In France, tuberculosis surveillance is based on mandatory notification (MN) of cases. However, the MN does not allow the full description of cases, and underreporting limits data interpretation. Aiming at better describing the cases of tuberculosis, the hospital record database (PMSI) was analyzed.
Incident cases of active pulmonary tuberculosis identified in 2010 in France in the PMSI were included and their characteristics were compared with those of the cases identified through the MN.
In 2010, 5158 incident cases of pulmonary tuberculosis were identified in the PMSI. The mean duration of hospitalization was higher for cases considered contagious — at least one positive test result on pulmonary sample — (22 vs 13 days, P < 0.001). Among all cases, 5% were infected by HIV. Death was reported for 4% of cases. The number of pulmonary TB cases reported in the MN was 3781 in 2010. PMSI data by sex, region of residence and month of diagnosis were similar with those of the MN but patients were older in the PMSI (52 vs 47 years, P < 0.001). Considering the PMSI as exhaustive, sensitivity of the MN was estimated at 73.3% in 2010.
PMSI data were compatible with those of the MN and the estimation of the sensitivity was close to other French studies. PMSI can be considered as an interesting tool aiming at improving our knowledge about tuberculosis (TB) cases and strengthening awareness where the sensitivity of the MN is low.
在法国，结核病监测基于病例的强制报告（MN）。然而，强制报告无法全面描述病例情况，且报告不足限制了数据解读。为了更好地描述结核病病例，对医院记录数据库（PMSI）进行了分析。
纳入2010年在法国PMSI中确诊的活动性肺结核新发病例，并将其特征与通过强制报告确定的病例特征进行比较。
2010年，PMSI中确诊了5158例肺结核新发病例。对于被认为具有传染性的病例——肺部样本检测至少有一次阳性结果——平均住院时间更长（22天对13天，P<0.001）。在所有病例中，5%感染了艾滋病毒。4%的病例报告死亡。2010年强制报告的肺结核病例数为3781例。PMSI中按性别、居住地区和诊断月份划分的数据与强制报告的数据相似，但PMSI中的患者年龄更大（52岁对47岁，P<0.001）。将PMSI视为详尽无遗的数据来源，2010年强制报告的敏感性估计为73.3%。
PMSI数据与强制报告的数据相符，敏感性估计与其他法国研究相近。PMSI可被视为一种有助于提高我们对结核病病例的认识并在强制报告敏感性较低的地区加强意识的有趣工具。
