Objective To analyze delay in student pulmonary tuberculosis (PTB) case-finding and associated factors in Suzhou, and to provide a reference for tuberculosis outbreak prevention and control in schools.
Methods A total of 1 148 students with PTB who registered and were treated in Suzhou from 2011 to 2020 were included. Kruskal-Wallis H test, 2 test and Cochran-Armitage trend test were used to analyze the time trend of case-finding delay. Logistic regression was used to analyze the correlation between admission characteristics and case-finding delay.
Results Among the students with PTB, a total of 569 cases were found to be delayed. The rate of delay was 49.6%, and the median delay time was 26 (11–49) days. From 2011 to 2020, the difference in case-finding interval of students with PTB was statistically significant ( Hc = 54.62, P<0.05), and the difference in case-finding rate was also statistically significant (χ 2 = 53.69, P<0.05). The rate of delay fluctuated, with an overall upward trend over time ( Z = −3.67, P<0.05). Clinical consultation ( OR = 5.57, 95% CI = 1.91-16.27), positive etiology ( OR =1.46, 95% CI = 1.14-1.86) were positively correlated with case-finding delay (all P<0.05).
Conclusion There are significant delays in case-finding among students with PTB in Suzhou. Clinical consultation and positive etiology are associated with case-finding delay. In response to the growing problems in daily school tuberculosis prevention and control, multiple departments should cooperate to implement relevant measures and to reduce the occurrence of case-finding delay.
【摘要】 目的 分析苏州市学生肺结核患者发现延迟情况, 为学校结核病疫情防控工作提供参考依据。 方法 以 2011—2020 年苏州市登记管理的 1 148 例学生肺结核患者为研究对象, 采用 Kmskal-Wallis H 检验、χ 2 检验和 Cochran-Armitage 趋势检验分析学生肺结核患者发现延迟的时间趋势, 采用 χ 2 检验和 Logistic 回归分析学生肺结核患者人院特征与发现延 迟的关系。 结果 调査的学生肺结核患者中, 共有 569 例发现延迟, 发现延迟率为 49.6%, 发现时长中位数为 26 (11~49) d。2011—2020 年学生肺结核患者发现时长差异有统计学意义 ( Hc = 54.62, P<0.05), 发现延迟率 (51.2%, 44.2%, 33.9%, 26.2%, 65.8%, 51.0%, 43.2%, 61.5%, 55.0%, 53.5%) 差异有统计学意义 (χ 2 = 53.69, P<0.05)。发现延迟率随时间变化而波 动, 总体呈上升趋势 ( Z = −3.67, P<0.05)。发现方式为因症就诊 ( OR = 5.57, 95% CI = 1.91~16.27)、病原学检査结果为阳性 ( OR =1.46,95% CI = 1.14~1.86) 均与发现延迟呈正相关 ( P 值均<0.05)。 结论 苏州市学生肺结核患者发现延迟情况不容 乐观, 因症就诊、病原学检査阳性是发现延迟的影响因素。针对日常学校结核病防控中的突出问题, 多部门应联动合作落 实相关防控措施, 减少发现延迟的发生。