摘要
目的分析贵州省利福平耐药肺结核患者的纳入治疗情况及影响因素,为完善防控策略提供依据。方法基于2016—2023年贵州省肺结核患者个案、耐药筛查登记和耐药患者个案信息,用率(%)描述利福平耐药患者纳入治疗的分布特征,采用χ^(2)检验和二分类logistic回归模型分析其影响因素。结果2016—2023年贵州省利福平耐药肺结核患者年均纳入治疗率为56.00%,从2016年35.71%上升至2023年88.20%(趋势χ^(2)=729.839,P<0.001)。其中,男性、女性,<20岁、20~39岁、40~59岁和≥60岁和9个市(州)均呈上升趋势(P均<0.05)。影响因素分析显示,与<20岁、本地、新患者、检测报告单位为耐多药结核病定点医院和没有发生确诊延迟的患者相比,≥60岁(OR=0.471,95%CI:0.296~0.750)、流动(OR=0.503,95%CI:0.391~0.646)、初治2/3月末阳性(OR=0.676,95%CI:0.464~0.983)、检测报告单位为普通肺结核定点医院(OR=0.080,95%CI:0.063~0.102)与疾控中心(OR=0.048,95%CI:0.040~0.057)以及发生确诊延迟(OR=0.551,95%CI:0.048~0.648)是患者纳入治疗的危险因素(P均<0.05)。结论贵州省利福平耐药肺结核患者纳入治疗情况逐步改善,仍需持续重视。建议对≥60岁、流动、初治2/3月末阳性、检测报告单位为非耐多药定点结核以及发生确诊延迟患者等重点人群加强干预,继续提升患者的纳入治疗情况。
Objective To analyze the treatment enrollment status and influencing factors for rifampicin-resistant pulmonary tuberculosis patients in Guizhou Province, providing a basis for improving prevention and control strategies. Methods Based on case data, drug resistance screening records, and information on drug-resistant patients in Guizhou Province from 2016 to 2023, the enrollment rate (%) of rifampicin-resistant patients was described to characterize their distribution. Chi-square tests and binary logistic regression models were employed to analyze influencing factors. Results The average annual enrollment rate for rifampicin-resistant pulmonary tuberculosis patients in Guizhou Province from 2016 to 2023 was 56.00%, increasing from 35.71% in 2016 to 88.20% in 2023 (trend χ^(2)=729.839, P<0.001). An upward trend was observed across gender, age groups (<20 years, 20-39 years, 40-59 years, and ≥60 years), and nine municipalities (P<0.05 for all). Analysis of influencing factors indicated that compared to patients who were <20 years old, local, new cases, those with reports from designated multidrug-resistant tuberculosis hospitals, and those without diagnosis delays, the following were identified as risk factors for treatment enrollment: age ≥60 years (OR=0.471, 95%CI: 0.296-0.750), migrant status (OR=0.503, 95%CI: 0.391-0.646), initial treatment positive at 2/3 months (OR=0.676, 95%CI: 0.464-0.983), reports from general tuberculosis hospitals (OR=0.080, 95%CI: 0.063-0.102) and from the disease control center (OR=0.048, 95%CI: 0.040-0.057), and diagnosis delays (OR=0.551, 95%CI: 0.048-0.648) (P<0.05 for all). Conclusion The treatment enrollment status of rifampicin-resistant pulmonary tuberculosis patients in Guizhou Province has gradually improved, but continued attention is necessary. It is recommended to strengthen interventions for key populations, including those aged ≥60 years, migrants, initial treatment positive at 2/3 months, patients with reports from non-multidrug-resistant designated tuberculosis hospitals, and those experiencing diagnosis delays, to further enhance treatment enrollment rates.
作者
马晓雪
饶文
郭生琼
陈璞
周建
刘益宁
罗珑
陈再平
陈美
李进岚
MA Xiao-xue;RAO Wen;GUO Sheng-qiong;CHEN Pu;ZHOU Jian;LIU Yi-ning;LUO Long;CHEN Zai-ping;CHEN Mei;LI Jin-lan(Institute of Tuberculosis Prevention and Control,Guizhou Provincial Center for Disease Control and Prevention,Guiyang,Guizhou 550004,China;不详)
出处
《现代预防医学》
北大核心
2025年第9期1694-1699,1712,共7页
Modern Preventive Medicine
基金
贵州省发改委省级基本建设前期工作项目(2020-181-131)
贵州省疾病预防控制中心2024年青年科学基金项目(2024-E-7)。
关键词
肺结核
耐药
纳入治疗
影响因素
Pulmonary tuberculosis
Drug resistance
Treatment enrollment
Influencing factors
作者简介
马晓雪(1996-),女,硕士,主管医师,研究方向:疾病预防与控制;通信作者:李进岚,E-mail:740820442@qq.com。
