The Epidemiology Characteristics And Influential Factors Of Tuberculosis In Shengli Oilfield

BackgroundTuberculosis is a kind of chronic respiratory infective disease around the world, with greatly harmful effect to human being. China is one of the 22 most infective countries in the world, with 17% people with tuberculosis of the world, just second to India. Additionally, our country greatly bears the multi-drug tuberculosis serious situation, is one of 27tuberculosis high MDR-TB burden countries. In December,2000 and in September,2004 State Council held the nation tuberculosis picturep hone meeting two times. And in 2004, they listed AIDS, schistosomiasis and tuberculosis as the main work, and implemented the modern tuberculosis control strategy around the country. The Shengli Oilfield subordinates to the China SINOPEC, is composed of the Shengli administrative bureau and the Shengli Oilfield subsidiary company. In our country, the state-owned extra large type enterprise is relative independent, and the scale is equal to the prefecture, but different in the mode of administration with the prefecture, which has its own health insurance policy, the going see a doctor pattern. The Shengli Oilfield, with 430,000 population state-owned extra large type enterprises, prevents and controls the aspect at tuberculosis to have its particularity, in aspects and the government and so on policy system, organization personnel manages existence certain disparity. Monitors in the reporting technology system at the Shandong Province disease, has not carried on systematically, the comprehensive analysis to the Shengli Oilfield tuberculosis epidemic situation popular characteristic and the influential factor aspect. This research subject is for the purpose of unifying the Shengli Oilfield tuberculosis prevention and control work the present situation and the characteristic, conducts the analytical study to the Shengli Oilfield tuberculosis epidemic situation characteristic and the influencing factor, describes tuberculosis epidemic situation present situation and the epidemiology characteristic, analyzes tuberculosis morbidity related influencing factor, the understanding current tuberculosis prevention and control effect and the existence insufficiency and so on. Through tuberculosis epidemic situation present situation analysis, the objective evaluation present oilfield tuberculosis epidemic situation characteristic and the prevention and control work result, proposed that suits the oilfield prevention and control pattern the suggestion, does the tuberculosis control efforts for the State-owned business to provide the scientific basis, enhances tuberculosis prevention and control effect.Objectives1. Understand the status of Shengli Oilfield and epidemiological features of tuberculosis.2. Do analysis of Shengli Oilfield, TB-related factors.3. TB prevention and control of Shengli Oilfield proposed recommendations.Method1.2005～2008, Shengli Oilfield, direct reporting network and data network special report descriptive epidemiological analysis using Excel software for statistical analysis the epidemiological characteristics of tuberculosis in Shengli Oilfield.2.From 2004 to 2008, Shengli Oilfield in different regions and different groups of TB screening data, using the SPSS statistics 17.0 software for statistical analysis, Shengli Oilfield tuberculosis epidemic situation.3. Through qualitative interviews with relevant personnel, including key health institutions of the Shengli oil field to conduct interviews, surveys the basic socio-economic and health services as well as on the diagnosis of pulmonary tuberculosis patients a questionnaire survey to understand the socio-economic Shengli Oilfield, health services and the basic situation of TB prevention and control analyze the field of TB and TB Control in the Risk Factors.ResultsFirst,2005～2008, the incidence of tuberculosis reported.1.2005～2008, the average reported incidence rate of 29.45/10 million, the highest incidence reported in 2005, to 37.62/10 million. The reported incidence of the various communities in the level of disparity, there are significant regional differences.2. TB incidence has obvious seasonal trend in the overall incidence of 1 in February at a low level of incidence, in March began to increase in June and then gradually declined to the lowest in December.3. Tuberculosis incidence of occupational distribution of workers the most, followed by the retired staffs, these two groups the total number of disease accounted for 59.4% incidence of disease for at least the business services and catering industry. The highest incidence of occupational report is retired staffs, followed by workers.4. The reported incidence of tuberculosis of male to female ratio of 1.98:1, the peak incidence in the 20 to 40 age group and 50 to 70 age group, the incidence declined more than 70 years.5. TB patients with type III main type,98.5% of patients receiving regular treatment, smear positive pulmonary tuberculosis patients with smear negative pulmonary tuberculosis patients and treatment success rates were 95.9% and 98.0%.Second,2004～2008, the prevalence of tuberculosis in different population1. Screen positive rate of 43.45% population, strong positive rate of 8.26%, the overall infection rate of 50.47%, no significant downward trend in infection rates. The rise rate of infection increased with age, oil central city than surrounding areas, the infection rate high and low population density with units of the degree.2. Screening population prevalence of active pulmonary tuberculosis in the 144.23/10 million to 350.64/10 million smear-positive prevalence rate of 33.50/10 66.97/10 million million to the overall low prevalence rate. Prevalence of active pulmonary tuberculosis men than women, the prevalence ratio was 1.09:1, the prevalence increased with age, retired personnel a high prevalence, case detection by most workers, the prevalence of field center City higher than the surrounding area.3. Screening detected 67 cases of active tuberculosis cases, active pulmonary tuberculosis of new cases were 77.6%, low rate of tuberculosis patients was found.15 cases of tuberculosis screening prior to the discovery of methods known to doctor because of disease, accounting for 73.3%, the proportion of health screening and referral low. All 67 cases of pulmonary tuberculosis typeⅢwere receiving regular treatment, chemotherapy administration based mainly on the whole management.Third, qualitative interviews1. Shengli Oil Field is a state-owned large enterprises, registered medical institutions 145. 2008, the total revenue 570 million yuan,267 million health funding. Oil field in accordance with existing medical insurance policy, "Authority of the basic medical insurance system Trial Measures" and the seven supporting measures implemented, the coverage of medical insurance coverage, including family members, various groups, including children. Distribution of medical and health services in the field nine communities, the families of oil workers in the field of medical insurance cards coin is within the scope of any medical and health institutions for treatment, TB Medicare reimbursement in accordance with the basic policy implementation field.2. Tuberculosis find a way to cope with disease-based doctor,Ⅲpulmonary tuberculosis more common, can receive formal treatment for the whole journey as the main way. Survey showed that the oil field tuberculosis patients TB generally basic place of work, availability of good medical care, the financial burden of TB is not heavy, oil and chronic medical insurance reimbursement policies more acceptable to patients with non-free medication.3. Oilfield Work in TB prevention and control of TB imperfect system, special fields of work and planning TB control guidelines need to further explore the organic integration, centralized management of TB patients are not in place, and referral patterns of patients found to be further standardized, full treatment of Supervisory Management imperfect, TB social mobilization and health education effect is not obvious major problems.Conclusions1. The reported incidence of tuberculosis in Shengli Oilfield is very different in the different communities, age, occupational distribution to employees of working age is high.2. The rate of TB infection in Shengli Oilfield higher than the national rate, but the prevalence of TB is low, male, retired personnel a high prevalence rate of infection and illness rates are higher than the oil fields around downtown.3. Shengli Oilfield, have lower detection rate of TB patients, the main way for the whole management of chemotherapy administration.4. Economic situation of the families of oil workers, medical insurance, benefits and availability of medical treatment are well, and oil field medical insurance policy with, chronic diseases such claims insure the pulmonary tuberculosis patient can be timely and effective treatment.5. Oil field can be combined in tuberculosis control with the practical field, carefully study and analyze the work of the special TB field to explore the practical integration with the national implementation measures, continue to increase spending on effective TB prevention and control.6. Network of TB prevention and control in oilfields is not perfect,.There is not enough institutional capacity to TB control management, some TB patients can't accecpt chemotherapy full supervisory or management requirements.7. The clinicians awareness of tuberculosis is poor, the suspicious cases of tuberculosis in health care institutions in sputum smears taken in the proportion of low, referral percentage is still low.8. Oilfield TB propaganda is not enough, people access to TB prevention knowledge and policies from TV, Internet, billboards and other media channels is low proportion.