1999-2008年上海市流动人口肺结核流行特征

发布时间：2018-03-31 23:11

本文选题：上海　切入点：流动人口　出处：《复旦大学》2013年硕士论文

【摘要】：目的分析1999-2008年上海市流动人口中肺结核病患者的登记情况、管理依从性和治疗效果,并与上海市户籍人口进行比较；描述流动人口肺结核病的流行病学特点,为完善上海市流动人口结核病防治政策,控制流动人口中的结核病流行提供科学依据。方法利用上海市结核病监测网络的监测信息,对1999-2008年间在《上海市结核病患者登记卡》和结核病登记管理信息系统中登记的上海市流动和户籍人口中的81817例肺结核患者,记录年龄、性别、职业、户籍地、日期、化疗史、发现和管理方式、治疗结局等信息,利用Office Excel 2007进行资料整理,Stata/SE11.0进行统计分析。结果1999-2008年间,上海市流动人口肺结核患者登记人数总体呈上升趋势,但登记率呈逐年下降趋势,由1999年的108.1/10万下降至2008年的44.0/10万,而同期户籍人口肺结核患者登记人数和登记率均呈缓慢下降趋势,并趋于平稳,登记率由1999年的43.1/10万人下降至2008年的28.4/10万人。流动人口肺结核患者登记人数占全市肺结核患者登记总数的比例,从1999年的32.7%增加到2008年的近50%,10年中流动人口肺结核患者登记率显著高于户籍人口。从地区分布来看,流动人口肺结核患者登记人数较多的区(县)是杨浦区、浦东新区和闵行区,最少的是崇明县。大多数区(县)流动人口登记率均明显高于户籍人口,登记率最高的3个区分别为杨浦区、徐汇区、卢湾区。流动人口肺结核患者主要来自安徽、江苏、浙江、四川4省,超过总登记人数的60%。流动人口肺结核患者男女性别比约为1.8：1；登记者中以中青年为主,15-29岁和30-49岁年龄段占80%以上。流动人口肺结核患者主要职业依次是农民、民工、家务及待业和工人,占60%以上。流动人口肺结核患者复治比例呈逐年上升趋势,平均复治比例约为9%,但仍显著低于户籍人口的14%。2005-2008年流动人口肺结核患者主动发现率约为10%,高于户籍人口的7%。流动人口和户籍人口肺结核患者DOTS覆盖率均逐年上升,2008年分别达到85.48%和92.10%,流动人口肺结核患者DOTS覆盖率提高较快,但仍显著低于户籍人口。2005-2008年流动人口肺结核患者总体完成治疗率、涂阳肺结核患者治愈率、初治涂阳肺结核患者治愈率、复治涂阳肺结核患者治愈率及涂阴肺结核患者完成治疗率均明显上升,2008年已分别达到81.7%、76.1%、76.9%、69.2%和84.8%,但仍与同时期户籍人口相应治疗效果有较大的差距。结论 1999-2008年上海市流动人口肺结核患者登记人数呈上升趋势,在全市患者中所占比例越来越大,登记率明显下降,但仍显著高于户籍人口。与户籍人口相比,流动人口肺结核患者在年龄、性别、职业、地域和时间分布上均表现不同的特征。流动人口肺结核患者的管理依从性较差,DOTS覆盖率和各项治疗效果指标虽有明显上升,但仍显著低于户籍人口。
[Abstract]:Objective to analyze the registration, management compliance and therapeutic effect of pulmonary tuberculosis in floating population of Shanghai from 1999 to 2008, and to compare it with the resident population of Shanghai, and to describe the epidemiological characteristics of pulmonary tuberculosis in floating population.To improve the Shanghai floating population tuberculosis control policy and control of tuberculosis in the floating population to provide scientific basis.Methods based on the surveillance information of Shanghai Tuberculosis Surveillance Network, 81817 cases of tuberculosis patients registered in Shanghai floating and registered population in Shanghai from 1999 to 2008 were analyzed, including the Shanghai TB patient Registration Card and the TB Registration Management Information system.Data of age, sex, occupation, domicile, date, history of chemotherapy, discovery and management, outcome of treatment were recorded, and Office Excel 2007 was used for statistical analysis.Results from 1999 to 2008, the number of pulmonary tuberculosis patients registered in Shanghai's floating population showed an overall upward trend, but the registration rate decreased year by year, from 108.1 / 100 million in 1999 to 44.0 / 100 million in 2008.In the same period, the number of registered pulmonary tuberculosis patients and the registration rate showed a slow downward trend, and tended to steady, the registration rate fell from 43.1 / 100,000 in 1999 to 28.4 / 100,000 in 2008.The proportion of registered pulmonary tuberculosis patients in floating population increased from 32. 7% in 1999 to nearly 50% in 2008. The registration rate of pulmonary tuberculosis patients in floating population in 10 years was significantly higher than that in household registration population.In terms of regional distribution, the areas (counties) with large number of registered tuberculosis patients in floating population are Yangpu District, Pudong New area and Minhang District, and the least one is Chongming County.The registration rate of floating population in most districts (counties) is obviously higher than that in household registration population, and the three districts with the highest registration rate are Yangpu District, Xuhui District and Luwan District respectively.The floating population mainly comes from Anhui, Jiangsu, Zhejiang and Sichuan provinces, accounting for more than 60 percent of the registered population.The sex ratio of male and female patients with pulmonary tuberculosis in floating population was about 1.8: 1, and 80% of them were aged 15-29 years and 30-49 years old.The main occupations of pulmonary tuberculosis in floating population were farmers, migrant workers, household and unemployed workers, accounting for more than 60%.The proportion of recurrent pulmonary tuberculosis patients in floating population is increasing year by year, the average rate of re-treatment is about 9, but it is still significantly lower than the rate of active detection of pulmonary tuberculosis in floating population in 2005-2008, which is about 10 percent, which is higher than that of household registration population.The DOTS coverage rate of the floating population and the household registered population with pulmonary tuberculosis increased year by year, reaching 85.48% and 92.10% respectively in 2008. The DOTS coverage rate of the floating population patients with pulmonary tuberculosis increased rapidly.But it is still significantly lower than that of the floating population from 2005 to 2008, the cure rate of smear positive pulmonary tuberculosis patients, the cure rate of initial smear positive pulmonary tuberculosis patients, and the cure rate of initial smear positive pulmonary tuberculosis patients.The cure rate of retreated smear positive pulmonary tuberculosis patients and the complete treatment rate of smear smear positive pulmonary tuberculosis patients increased obviously, reaching 81.776. 1% and 84.8% respectively in 2008, but there was still a big difference with the corresponding treatment effect of household registration population in the same period.Conclusion from 1999 to 2008, the number of pulmonary tuberculosis patients registered in floating population of Shanghai is on the rise, and the proportion of patients in the whole city is more and more. The registration rate is obviously decreased, but still significantly higher than that of household registration population.Compared with household registration population, pulmonary tuberculosis patients in floating population showed different characteristics in age, sex, occupation, region and time distribution.The poor compliance of pulmonary tuberculosis patients in floating population and dots coverage rate and treatment effectiveness index increased significantly, but still significantly lower than the household registration population.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R521;R181.3

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