National Center for TB Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Int J Environ Res Public Health. 2021 Feb 25;18(5):2264. doi: 10.3390/ijerph18052264.
(1) Background: The reliability of disease surveillance may be restricted by sensitivity or ability to capture all disease. Objective: To quantify under-reporting and concordance of recording persons with tuberculosis (TB) in national TB surveillance systems: the Infectious Disease Reporting System (IDRS) and Tuberculosis Information Management System (TBIMS). (2) Methods: This retrospective review includes 4698 patients identified in 2016 in China. County staff linked TB patients identified from facility-specific health and laboratory information systems with records in IDRS and TBIMS. Under-reporting was calculated, and timeliness, concordance, accuracy, and completeness were analyzed. Multivariable logistic regression was used to examine factors associated with under-reporting. (3) Results: We found that 505 (10.7%) patients were missing within IDRS and 1451 (30.9%) patients were missing within TBIMS. Of 171 patient records reviewed in IDRS and 170 patient records in TBIMS, 12.3% and 6.5% were found to be untimely, and 10.7% and 7.1% were found to have an inconsistent home address. The risk of under-reporting to both IDRS and TBIMS was greatest at tertiary health facilities and among non-residents; the risk of under-reporting to TBIMS was greatest with patients aged 65 or older and with extrapulmonary TB (EPTB). (4) Conclusions: It is important to improve the reporting and recording of TB patients. Local TB programs that focus on training, and mentoring high-burden hospitals, facilities that cater to EPTB, and migrant patients may improve reporting and recording.
(1) 背景：疾病监测的可靠性可能受到敏感性或捕捉所有疾病的能力的限制。目的：量化国家结核病监测系统中结核病（TB）患者报告不足和记录一致性：传染病报告系统（IDRS）和结核病信息管理系统（TBIMS）。(2) 方法：本回顾性研究纳入了 2016 年在中国发现的 4698 例患者。县级工作人员将从医疗机构特定卫生和实验室信息系统中确定的结核病患者与 IDRS 和 TBIMS 中的记录联系起来。计算报告不足率，并分析及时性、一致性、准确性和完整性。采用多变量逻辑回归分析与报告不足相关的因素。(3) 结果：我们发现，505 例（10.7%）患者在 IDRS 中缺失，1451 例（30.9%）患者在 TBIMS 中缺失。在 IDRS 中审查的 171 例患者记录和 TBIMS 中的 170 例患者记录中，分别有 12.3%和 6.5%的记录不及时，10.7%和 7.1%的记录家庭住址不一致。向 IDRS 和 TBIMS 报告不足的风险在三级卫生机构和非居民中最大；向 TBIMS 报告不足的风险在 65 岁或以上的患者和肺外结核病（EPTB）患者中最大。(4) 结论：提高结核病患者的报告和记录非常重要。针对培训和指导高负担医院、EPTB 患者和移民患者的地方结核病规划，可能会改善报告和记录。
