Wang X J, Fu Q, Zhang Z B, Lu Z Q, Tian D, Nan J, Wang J J, Li Y H
Tuberculosis Control and Management Office, Wuhan Institute for Tuberculosis Control, Wuhan Pulmonary Hospital, Wuhan 430030, China.
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2019 Jun 10;40(6):643-647. doi: 10.3760/cma.j.issn.0254-6450.2019.06.008.
To analyze the epidemiological characteristics, trend and related factors of tuberculosis patients that delayed for care, in Wuhan from 2008 to 2017. Data regarding tuberculosis (TB) patients was collected from the tuberculosis management information system (TMIS), a part of the China information system for disease control and prevention from 2008 to 2017. A total of 64 208 tuberculosis patients, aged 0 to 95 years were included for the analysis. Unconditional logistic regression method was used to estimate those factors that associated with this study. Days of delay among TB patients appeared as =10 (-: 3-28) day, in Wuhan, 2008-2017. The prevalence of the delay was 52.5% (33 703/64 208), presenting a downward trend from 2008 to 2017 (trend (2)=10.64, <0.001), but the proportions of women and ≥65 year-olds were gradually increasing. Results from the multivariate logistic regression analysis showed that factors as: patients living far away from the city . near the city (=1.29, 95: 1.25-1.35), and age above 45 years . younger than 25 years (the age 45-64 years group . aged less than 25 years group, =1.22, 95: 1.15-1.29; the age 65 or above group . aged less than 25 years group, the =1.30, 95: 1.22-1.39) were under higher risk on the delay of seeking care. Occupation, way of case-finding and classification of tuberculosis patients also appeared as influencing factors on this issue. Prevalence on the delay of care was 52.5% among tuberculosis patients in Wuhan, 2008-2017, but with an annual decrease. Attention should be paid to female, wrinkly or elderly tuberculosis patients regarding the delay of care on TB, in Wuhan.
分析2008年至2017年武汉市结核病患者延迟就医的流行病学特征、趋势及相关因素。从结核病管理信息系统(TMIS)收集2008年至2017年结核病患者的数据,该系统是中国疾病预防控制信息系统的一部分。共纳入64208例年龄在0至95岁的结核病患者进行分析。采用无条件逻辑回归方法评估与本研究相关的因素。2008 - 2017年武汉市结核病患者延迟天数为≥10天(范围:3 - 28天)。延迟患病率为52.5%(33703/64208),2008年至2017年呈下降趋势(趋势检验χ² = 10.64,P < 0.001),但女性和≥65岁人群的比例逐渐增加。多因素逻辑回归分析结果显示,居住在远离城市……靠近城市(比值比 = 1.29,95%置信区间:1.25 - 1.35),以及年龄在45岁以上……小于25岁(45 - 64岁年龄组……小于25岁年龄组,比值比 = 1.22,95%置信区间:1.15 - 1.29;65岁及以上年龄组……小于25岁年龄组,比值比 = 1.30,95%置信区间:1.22 - 1.39)的患者延迟就医风险较高。职业、病例发现方式和结核病患者分类也是该问题的影响因素。2008 - 2017年武汉市结核病患者延迟就医患病率为52.5%,但呈逐年下降趋势。在武汉市,对于结核病患者延迟就医问题,应关注女性、老年或高龄结核病患者。