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中国遵义 3 年住院结核病例调查:结核负担增加,但细菌学诊断得到改善。

Investigation of 3-year inpatient TB cases in Zunyi, China: Increased TB burden but improved bacteriological diagnosis.

机构信息

Tuberculosis Division of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China.

School of Basic Medicine, Zunyi Medical University, Zunyi, China.

出版信息

Front Public Health. 2022 Aug 2;10:941183. doi: 10.3389/fpubh.2022.941183. eCollection 2022.

Abstract

BACKGROUND

As one of the top three high tuberculosis (TB) burden countries, China is a country where the overall TB incidence continues to decline. However, due to its large population and area, the increased TB burden exists in regional areas.

METHODS

This retrospective study analyzed local inpatient pulmonary TB cases in the Affiliated Hospital of Zunyi Medical University (AHZMU) from January 2016 to December 2018 in a high TB incidence and economically-less-developed area of China. Four methods, acid-fast bacilli stain, culture, Xpert and LAMP, were used to detect (), while proportional method and Xpert were used to identify rifampicin-resistant TB (RR-TB). Case number, treatment history, confirmed TB and rifampicin resistant proportion were analyzed to investigate the local TB epidemic.

RESULTS

Total 3,910 local inpatient cases with pulmonary TB were admitted to AHZMU during this study period. The annual numbers of total TB cases increased 26.4% (from 1,173 to 1,483), while new cases increased 29.6% (from 936 to 1,213) and RR-TB cases increased 2.7 times (from 31 to 84). Meanwhile, the percentage of previously treated cases declined from 20.2 to 18.2% and the confirmed TB proportion increased from 34.7 to 49.7%.

CONCLUSION

The elevated confirmed TB proportion and the declined percentage of previously treated cases indicated the improved TB diagnosis and treatment of AHZMU. However, the increasing number of total TB cases, new and RR-TB cases showed an upward trend and increased TB burden in a relatively underdeveloped area of China.

摘要

背景

中国是结核病(TB)负担最高的三个国家之一,总体结核病发病率持续下降。然而,由于人口众多、地域辽阔,结核病负担在局部地区有所增加。

方法

本回顾性研究分析了中国高结核病发病率和欠发达地区遵义医科大学附属医院(AHZMU) 2016 年 1 月至 2018 年 12 月期间局部住院肺结核病例。共采用抗酸杆菌染色、培养、Xpert 和 LAMP 四种方法检测(),并采用比例法和 Xpert 检测利福平耐药结核(RR-TB)。分析病例数、治疗史、确诊结核病和利福平耐药比例,以调查当地结核病流行情况。

结果

本研究期间,AHZMU 共收治 3910 例局部住院肺结核患者。总结核病病例数增加 26.4%(从 1173 例增加到 1483 例),新发病例数增加 29.6%(从 936 例增加到 1213 例),RR-TB 病例数增加 2.7 倍(从 31 例增加到 84 例)。同时,既往治疗病例比例从 20.2%降至 18.2%,确诊结核病比例从 34.7%增至 49.7%。

结论

确诊结核病比例升高和既往治疗病例比例下降表明 AHZMU 的结核病诊断和治疗有所改善。然而,总结核病病例数、新发病例数和 RR-TB 病例数呈上升趋势,中国欠发达地区结核病负担加重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b121/9381004/5e018c1ee200/fpubh-10-941183-g0001.jpg

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