Epidemiological Characteristics Of Pulmonary Tuberculosis Among Floating Population In Shanghai During 1999-2008

Objective:To analyze and compare the registration situation, management compliance and treatment effect of pulmonary tuberculosis (PTB) patients between floating and household register population in Shanghai during 1999-2008; to describe the epidemiological characteristics to provide scientific basis for the improvement of policies and control the prevalence of floating population PTB.Methods:The age, gender, occupation, hometown, registration time, chemotherapy history, discovering mode, management method and treatment result distribution of 81817 PTB patients between floating and household register population in Shanghai were analyzed based on the registration card and management information system from Shanghai tuberculosis monitoring network during 1999-2008. Data processed by Office Excel 2007 and the statistical analysis was executed by Stata/SE 11.0.Results:The registration numbers of floating population PTB patients had a general rising trend in Shanghai during 1999-2008, and the registration rate was decreased year by year from 108.1/100,000 in 1999 to 44.0/100,000 in 2008. While the registration numbers and rate of household register population PTB patients both had a slow descending trend, and then changed to be steady, and the rate descended from 43.1/100,000 in 1999 to 28.4/100,000 in 2008. The proportion of floating population PTB patients’ registration numbers increased from 32.7% to nearly one half. The registration rate of floating population PTB patients was significantly higher than that of household register population during the 10 years. For district distribution, the most registration numbers of floating population PTB patients were in Yangpu, Pudong and Minhang District, and the lest was in Chongming County. The registration rate of floating population PTB patients was significantly higher than that of household register population in most districts. Yangpu, Xuhui and Luwan Districts had the highest registration rate. Floating population PTB patients were mainly from Anhui, Jiangsu, Zhejiang and Sichuan Province which accounted more than 60%in total. The sex ratio of floating population PTB patients was 1.8:1; most floating population PTB patients were young to middle-aged adults from 15-49 years old, accounting for more than 80%. For occupation distribution, the most were famers, peasant-workers, domestic workers and workers which accounted more than 60% in total. The proportion of re-treatment cases of floating population PTB patients increased year by year, which was about 9% in average, but was still significantly lower than that of household register population which was 14% in average. The rate of actively discovering of floating population PTB patients was about 10%, which was higher than 7% of the household register population during 2005-2008. The DOTS cover rates of both floating and household register population PTB patients increased year by year, which reached 85.48% and 92.10%. The DOTS cover rate of floating population PTB patients increased significantly than that of household register population but was still lower. The general complete treatment rate, smear-positive cure rate, initial treatment smear-positive cure rate, re-treatment smear-positive cure rate and smear-negative complete treatment rate of floating population PTB patients during 2005-2008 all increased fast, and reached 81.7%, 76.1%,76.9%,69.2% and 84.8% but still had a certain gap from those of the household register population.Conclusion:The registration numbers of floating population PTB patients had a general rising trend in Shanghai during 1999-2008, and took up an increasing proportion. Its registration rate was decreased year by year but was still significantly higher than that of household register population. In comparison with household register population, floating population PTB patients showed different characteristics in terms of age, gender, occupational, geographical and time distribution. The management compliance of floating population PTB patients was still very hard. The DOTS cover rate and treatment effect indexes of floating population PTB patients increased significantly than those of household register population but were still lower.