| Objective:This study describes the three distribution characteristics of pulmonary tuberculosis and etiological positive pulmonary tuberculosis in Jilin Province from 2016 to2020,understands the epidemic trend of pulmonary tuberculosis in Jilin Province,analyzes the factors affecting the positive detection rate of etiology by describing the positive detection rate of etiology in Jilin Province from 2016 to 2020,understands the epidemic characteristics of etiological positive pulmonary tuberculosis in Jilin Province.Analyze the influencing factors of non-negative result of sputum smear in pulmonary tuberculosis patients with positive etiology.Provide basis for tuberculosis prevention and control institutions to formulate corresponding strategies and measures in Jilin Province.Method:This study collected the medical record data of tuberculosis patients in Jilin Province from 2016 to 2020 from the tuberculosis information management system(medical record ID,first diagnosis area,gender,age,nationality,occupation,registered residence address,complications,diagnosis results,registration date,treatment classification,sputum smear examination)to perform descriptive analysis.The demographic data of Jilin Province are from the statistical yearbook of Jilin Province from 2016 to 2020.Excel 2020 software was used to sort and summarize data,and IBM SPSS statistics 24.0 software was adopted for statistical analysis.The measurement data according with normal distribution are described by " ± s",the counting data are described by "percentage" and "constituent ratio",and compare the differences between groups by chi square test,the trend of positive detection rate of etiology and negative conversion of sputum bacteria in 2016-2020 is tested by chi square trend test.With the pathogen positive patient as the dependent variable,the multivariate analysis of the pathogen positive detection of patients with different characteristics was conducted by using the unconditional logistic regression model.The covariates included were significant variables in the single factor analysis.Taking the non-negative result of sputum bacteria in 2 months as the dependent variable,the non conditional logistic regression model was applied to analyze the difference of positive result of sputum bacteria in patients with different characteristics after treatment.The covariates included were significant variables in the single factor analysis.The difference was statistically significant(P<0.05)by bilateral test.Result:1、Epidemiological characteristics of pulmonary tuberculosis in Jilin Province(1)General characteristics From 2016 to 2020,a total of 57200 pulmonary tuberculosis patients were registered in Jilin Province,with an annual average registration rate of43.83/100000.(2)Demographic characteristics Among the pulmonary tuberculosis patients registered in Jilin Province from 2016 to 2020,there were more males than females,and the gender ratio of males to females was 2.41:1.The average age was(48.42± 17.29)years.The 40-59 age group has the largest number of patients,accounting for 41.42%.Among all nationalities of China,the majority of patients were Han nationality,accounting for 95.66%.Farmers and herdsmen had the most patients in all occupations,accounting for 51.95%.Among the types of registered residence,local patients were the most,accounting for 88.80%.Among the patients with pulmonary tuberculosis complicated with diabetes or not,those without diabetes were the most,accounting for 96.45%.In the treatment classification,the number of newly diagnosed pulmonary tuberculosis patients was the largest,accounting for 93.81%.The patients with delay of seeking medical treatment were the most,accounting for 73.70%.Among all regions,Changchun has the most patients,accounting for 28.03%.(3)Time characteristics The registration rate increased year by year from 2016 to 2018,peaked in 2018 with a registration rate of 52.28/100000,and decreased year by year from 2018 to 2020 with a registration rate of 31.64/100000.(4)Regional characteristics Among the annual average registration rates of all cities in Jilin Province,the annual average registration rate of Jilin City is the highest,57.42/100000,while the annual average registration rate of Yanbian Prefecture is the lowest,36.76/100000.The annual average registration rate of Jilin City and Baicheng City is higher than the annual average registration rate of the whole province.2、Epidemiological characteristics of etiological positive pulmonary tuberculosis in Jilin Province(1)General characteristics From 2016 to 2020,a total of 25280 etiological positive pulmonary tuberculosis patients were registered in Jilin Province,with an annual average registration rate of 19.37/100000.(2)Demographic characteristics Among the pulmonary tuberculosis patients with positive etiology registered in Jilin Province from 2016 to 2020,there were more males than females,and the gender ratio of males to females was 2.83:1.The average age was(50.62±16.18)years.The 40-59 age group has the largest number of patients,accounting for 45.20%.Among all nationalities of China,the majority of patients were Han nationality,accounting for 95.16%.Farmers and herdsmen had the most patients in all occupations,accounting for 52.88%.Among the types of registered residence,local patients were the most,accounting for 90.21%.Among the patients with etiological positive pulmonary tuberculosis complicated with diabetes or not,those without diabetes were the most,accounting for 94.27%.In the treatment classification,the number of newly diagnosed pulmonary tuberculosis patients was the largest,accounting for 86.92%.The patients with delay of seeking medical treatment were the most,accounting for 72.69%.Among all regions,Changchun has the most patients,accounting for 26.77%.(3)Time characteristics Registration rate increased year by year from 2016 to 2018,peaked in 2018 with a registration rate of 24.48/100000,and the lowest was14.25/100000 in 2016,and decreased year by year from 2018 to2020.(4)Regional characteristics Among the annual average registration rates of all cities in Jilin Province,the annual average registration rate of Jilin City is the highest,26.45/100000,while the annual average registration rate of Songyuan City is the lowest,15.27/100000.The annual average registration rate of Jilin City,Baicheng City,Yanbian Prefecture and Meihekou City is higher than that of the province(19.37/100000).3、Analysis of the positive detection rate of etiology and its influencing factors in Jilin Province.From 2016 to 2020,there were 57200 pulmonary tuberculosis patients in Jilin Province,of which 25280 were etiologically positive,with a positive detection rate of 44.20%.There were statistically significant differences in the positive detection rate of etiology among different genders,ages,nationalities,occupations,registered residence types,complicated with diabetes or not,treatment classification,delay of seeking medical treatment,years and regions.The positive detection rate of etiology,which in men was higher than that in women,which was the highest in 40-59 years old,which in non Han patients was higher than that in Han patients,which in farmers and herdsmen was higher than that in others,which in local patients was higher than that in non-local patients,which in patients with diabetes was higher than that in patients without diabetes,which in retreated patients was higher than that in newly treated patients,which in patients without delay than in patients with delay.From 2016 to 2020,the positive detection rate of etiology showed an upward trend year by year.Yanbian Prefecture has the highest positive rate of etiology.The results of multivariate analysis showed that the risk of positive etiological examination in male pulmonary tuberculosis patients was 1.175 times higher than that in female pulmonary tuberculosis patients(95% CI: 1.129-1.222).The risk of positive etiological examination in patients aged40-59 years was 2.537 times that in patients aged 0-19 years(95%CI: 2.324-2.769).The risk of pulmonary tuberculosis positive in farmers and herdsmen was 1.044 times higher than that in other occupations(95% CI: 1.005-1.085).The risk of positive etiological examination in local TB patients was 1.216 times higher than that in non-local TB patients(95% CI: 1.147-1.289).The risk of pulmonary tuberculosis with diabetes was 2.259 times higher than that without diabetes(95% CI: 2.036-2.508).The risk of positive etiology test in retreated pulmonary tuberculosis patients was 19.248 times higher than that in newly treated pulmonary tuberculosis patients(95% CI:16.814-22.035).In 2020,the risk of positive etiological examination of pulmonary tuberculosis patients was 3.167 times that of 2016(95% CI: 2.977-3.368).The positive detection rate of pulmonary tuberculosis in Yanbian Prefecture was higher than that in other regions,1.824 times higher than that in Changchun City(95% CI: 1.688-1.970).4、Analysis of the influencing factors of non-negative result of sputum bacteria in patients with positive etiology in Jilin Province in 2 months after treatmentFrom 2016 to 2020,there were 25280 etiologically positive pulmonary tuberculosis patients in Jilin Province.After treatment according to the standard chemotherapy regimen,the number of patients whose sputum smear remained negative for 2months was 506,and the rate of sputum bacteria not negative for etiologically positive patients was 2.00%.There were statistically significant differences in sputum non negative conversion rate of etiology positive patients in different genders,ages,nationalities,complicated with diabetes or not,treatment classification,years and regions.The sputum non negative conversion rate of male etiology positive patients was higher than that of female.In all age groups,the sputum non negative conversion rate of patients aged 40-59 with positive etiology was the highest.The non negative conversion rate of sputum bacteria in non Han nationality patients with positive etiology was higher than that in Han nationality patients,which in patients with etiological positive diabetes was higher than that in patients without diabetes,the rate of which in patients with etiology positive in retreatment was higher than that in patients with newly treatment.From 2016 to 2020,the non negative conversion rate of sputum bacteria in etiological positive patients showed a downward trend year by year.In Meihekou City,the rate of sputum with non negative result was the highest among the patients with positive etiology.The results of multivariate analysis showed that the risk of sputum with non negative conversion in male patients is 1.297 times higher than that in female patients(95%CI:1.037-1.623).The risk of sputum with non negative conversion in the 40-59 group was the highest,2.628 times that of the 0-19 group(95% CI:1.225-5.635).The risk of negative sputum bacteria conversion in non Han people was 1.638 times higher than that in Han people(95% CI: 1.212-2.213).The danger of sputum bacteria negative conversion in patients with DM was 1.508 times higher than that in patients without DM(95% CI: 1.135-2.003).The danger of sputum bacteria non negative conversion in retreated patients was 1.370 times higher than that in newly patients(95% CI:1.077-1.742).The sputum bacteria non negative conversion rate of patients with positive etiology in 2020(OR=0.282)was the lowest.Siping City(OR=0.540)has the lowest rate of non negative sputum conversion,while Meihekou City has the highest risk of non negative sputum conversion,9.460 times that of Changchun City(95% CI: 6.628-13.503).Conclusions:1、From 2016 to 2020,the annual average registration rate of pulmonary tuberculosis in Jilin Province was lower than the national average level.The registration rate in each year showed a state of first rising and then falling.The annual average registration rate in Jilin City was the highest.The patients with pulmonary tuberculosis were mainly male,40-59 year old group,Han people,farmers and herdsmen,local,without diabetes,newly treatment and delay of seeking medical treatment.2、From 2016 to 2020,the registration rate of etiologically positive pulmonary tuberculosis patients in Jilin Province increased first and then decreased.The annual average registration rate of Jilin City was the highest.The etiologically positive pulmonary tuberculosis patients were mainly male,40-59 years old group,Han nationality,farmers and herdsmen,local,not combined with diabetes,newly treatment and delay of seeking medical treatment.3、From 2016 to 2020,the positive detection rate of etiology of pulmonary tuberculosis registered in Jilin Province showed a gradual upward trend.The positive detection rate of etiology of Jilin City,Siping City,Liaoyuan City,Baishan City,Yanbian Prefecture and Meihekou City was higher than that of Changchun City.Male,over 20 years old,farmers and herdsmen,local,complicated with diabetes and retreatment were the risk factors for positive etiology of pulmonary tuberculosis patients.4、From 2016 to 2020,the sputum negative conversion rate of etiologically positive pulmonary tuberculosis patients registered in Jilin Province at the end of 2 months after treatment showed a gradually decreasing trend.The sputum negative conversion rate of etiologically positive pulmonary tuberculosis patients in Jilin City,Songyuan City,Yanbian Prefecture and Meihekou City was higher than that in Changchun City.The risk factors for the sputum negative conversion of etiologically positive pulmonary tuberculosis patients were male,40-59 years old,non-Han nationality,complicated with diabetes and retreatment. |
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