武汉市2008-2017年结核病患者就诊延迟情况及影响因素分析

摘要

Objective To analyze the epidemiological characteristics,trend and related factors of tuberculosis patients that delayed for care,in Wuhan from 2008 to 2017.Methods 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.Results Days of delay among TB patients appeared as M=10 (P25-P75:3-28) 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 x2=10.64,P＜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 vs.near the city (OR=1.29,95％CI:1.25-1.35),and age above 45 years vs.younger than 25 years (the age 45-64 years group vs.aged less than 25 years group,OR=1.22,95％CI:1.15-1.29;the age 65 or above group vs.aged less than 25 years group,the OR=1.30,95％CI: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.Conclusions 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.%目的 分析2008-2017年武汉市结核病患者就诊延迟行为特征、变化趋势及其影响因素,为结核病防治提供依据.方法 利用中国疾病预防控制信息系统结核病管理信息系统,收集2008-2017年武汉市64208例0～95岁结核病患者病案信息,采用非条件多因素logistic回归模型分析结核病患者就诊延迟的影响因素.结果 2008-2017年武汉市结核病患者的就诊天数为M=10(P25～P75:3～28)d,就诊延迟率为52.5％(33 703/64208),总体呈下降趋势(趋势x2=10.64,P＜0.001).结核病就诊延迟者主要为男性,女性、≥65岁组所占的构成比逐渐增长.多因素logistic回归分析结果显示,远城区(与近城区相比,OR=1.29,95％CI:1.25～1.35)、≥45岁组(45～、≥65岁组与＜25岁组相比,OR=1.22,95％CI:1.15～ 1.29;OR=1.30,95％CI:1.22～1.39)是结核病患者就诊延迟的危险因素,职业、患者来源和患者分类也是结核病患者就诊延迟的影响因素.结论 2008-2017年武汉市结核病患者的就诊延迟率总体呈下降趋势.应重点关注结核病患者中的女性和中老年就诊延迟者.