ABSTRACT
@#Abstract: Objective To analyze the treatment outcomes of elderly patients with pulmonary tuberculosis in Chongqing, so as to provide reference for the prevention and control strategies of the epidemic of elderly pulmonary tuberculosis. Methods The data of tuberculosis cases aged ≥65 years in Chongqing from 2015 to 2020 were collected from the National Health Insurance Information Project Disease Prevention and Control Information system. Descriptive statistical methods were used to analyze the data. Results The registration rates of elderly active pulmonary tuberculosis patients and etiological positive patients were 110.95/10-5and 32.25/10-5 in 2015 and 84.06/10-5 and 57.29/10-5 in 2020. The annual decline rate of active tuberculosis registration was 5.40%, and the annual increase rate of pathogenic-positive tuberculosis registration was 12.18%. The registration rates of active tuberculosis patients and etiological positive patients in the whole population were 70.75/10-5 and 17.63/10-5 in 2015 and 50.34/10-5 and 29.14/10-5 in 2020. The annual decline rate of active tuberculosis registration was 6.58%, and the annual increase rate of pathogenic-positive tuberculosis registration was 10.57%. From 2015 to 2020, a total of 25 931 cases of elderly pulmonary tuberculosis were registered, of which 21 374 (82.43%) cases were successfully treated and 4 010 (15.80%) cases had unfavorable outcomes. The proportion of cured and death patients showed an increasing trend year by year (χ2trend=313.853, 100.502, P<0.01). From 2015 to 2020, the average annual successful treatment rate of elderly pulmonary tuberculosis in the whole city was 82.43%, with the lowest rate in southeast Chongqing (74.23%), followed by urban areas (81.99%). The success rate of elderly pulmonary tuberculosis treatment in the whole city, west Chongqing, northeast Chongqing and southeast Chongqing showed a downward trend year by year (χ2trend=230.199, 35.278, 108.076, 112.130, all P<0.01), with annual decline rates of 2.77%, 2.26%, 3.0% and 4.12%, respectively. Among the registered elderly patients, female, 65-<75 years old, Han nationality, newly diagnosed, no complications, and negative for etiology (χ2=15.234, 255.910, 146.842, 179.998, 25.575, 131.170, P<0.01) had higher success treatment rates. Conclusions The prevalence of pulmonary tuberculosis in the elderly population in Chongqing City is declining, but the positive registration rate of etiology is increasing annually, and the success rate of treatment is decreasing. Therefore, it is necessary to strengthen the systematic management, publicity and education of elderly patients (especially those in southeast Chongqing, male, positive patients and severe patients) to effectively control the epidemic of tuberculosis in the elderly.
ABSTRACT
Objective@#To understand the current situation of school tuberculosis prevention and control system and the implementation of daily prevention and control measures, and to provide a reference for strengthening the prevention and control of tuberculosis in schools.@*Methods@#A random sampling method was used to select schools where on site questionnaire survey was carried out, including 156 junior high schools, 78 senior high schools and 6 universities. SPSS 25.0 was used for descriptive analysis and chi square test.@*Results@#The average annual screening rates of junior high school, senior high school and university from 2015 to 2020 were 58.84%, 71.71% and 84.41% respectively, and the difference was statistically significant ( χ 2=61 247.39， P <0.01). The average annual TB detection rates were 8.69/10 5, 50.89/10 5 and 36.51/10 5 respectively, and the difference was statistically significant ( χ 2=101.20， P <0.01). The screening rate of TB screening in 2015-2020 years increased by year( χ 2 trend =70 052.10, 86 182.82 , 22 213.56， P <0.01). The detection rate of TB among junior high schools and high schools has been increasing year by year( χ 2 trend =9.27, 12.23, P <0.01). From 2015 to 2020, the proportion of tuberculosis screening, contact history, PPD and chest screening increased by year in junior high school and senior high school freshmen, and the difference was statistically significant ( χ 2=129.10, 118.10, 206.92, 37.67; 108.79, 84.90, 139.84, 51.82, P <0.01). The proportion of chest X ray screening in universities increased by year( χ 2 trend =18.33， P <0.01). In 2019, poor performance on TB control in universities mainly included, including the school responsibility system for tuberculosis prevention and control, the school s annual TB work plan and absenteeism registration and etiology tracing, the proportion was 50.00 %, 0 and 16.67% respectively, compared with junior high school and senior high school, the difference was statistically significant( P <0.05). The prevalence rates of junior high school, senior high school and university students were 33.75/10 5, 90.10/10 5 and 54.20/10 5 respectively in 2019, and the difference was statistically significant ( χ 2=104.36， P <0.01).@*Conclusion@#The proportion of TB screening for freshmen in Chongqing increased significantly during 2015- 2020. High school students are still the focus of school based tuberculosis prevention and control. Improving the proportion of tuberculosis screening，strengthening and standardizing physical examination and screening，and establishing a clear responsibility system for prevention and control are effective means to prevent and control the spread of tuberculosis on campus.
ABSTRACT
Objective@#To provide the evidence for tuberculosis pvevalence for high school freshmen by analyzing data of entrance physical exarnination of Chongqing in 2018.@*Methods@#The TB information management system of schools in Chongqing was used to collect the data of TB physical examination for high school freshmen in 2018. Excel 2007 was used to establish database, SPSS 25.0 software was used for statistical analysis, including descriptive analysis, chi square test.@*Results@#In 2018, a total of 118 370 freshmen from 146 general education high schools and a total of 30 842 freshmen from 30 secondary vocational schools had TB screening during physical examination for freshmen. The proportion of school and freshmen participating in the TB examination was 40.09% and 44.28% respectively. The rates of school (57.03%) and freshmen (58.81%) participating in the examination of tuberculosis in senior high school students of general education were higher than those in secondary vocational education schools(16.39%, 22.73%), the difference was statistically significant(χ2=73.38, 42 744.64, P<0.01). 84 cases of active pulmonary tuberculosis (APTB) were detected in the physical examination of high school freshmen, mainly smear negative patients (92.86%)，and there was no significant difference in the prevalence of tuberculosis among the freshmen with different education, school and screening methods(P>0.05). The detection rates of TB among freshmen in general education and vocational education were 49.00/100 000 and 54.62/100 000 respectively. The detection rates of tuberculosis among freshmen in public schools and private schools were 50.29/100 000 and 124.88/100 000 respectively(χ2=5.42, 10.92, P<0.05). The detection rate of direct chest X-ray examination was 62.90/100 000. The first screening method was PPD test and the detection rate of chest X-ray examination was 84.30/100 000 for those with strong positive PPD test, the differences was no significant(χ2=0.29, P>0.05).@*Conclusion@#The tuberculosis screening program for high school freshmen is of great significance to the prevention and control of tuberculosis. Effective screening methods should be adopted and strengthened in secondary vocational schools.