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在老年人中进行大规模结核查:在中国东部一个狭窄的农村县进行基于人口的研究
Zhengfang Hu1, Kui Liu2, Meng Zhou3
1Department of Communicable Disease Control and Prevention, Lanxi Municipal Center for Disease Control and Prevention, Jinhua, Zhejiang Province, People's Republic of China.
概括
在中国,大规模结核病 (TB) 查发现老年人患结核病的病例增加了44%,尤其是无症状的病例. 这种方法通过检测基本医疗保险的人群中的结核病来改善健康公平.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 传染病控制和控制传染病
背景情况:
- 对高风险群体推进行大规模结核病 (TB) 查,但基于人口的实施和对健康公平的影响仍未得到充分研究.
- 之前的研究并没有广泛评估不同人群中大规模结核病查干预措施的有效性.
研究的目的:
- 评估中国农村老年人群中大规模结核病查干预措施的有效性.
- 评估大规模查对结核病例发现和健康公平的影响.
主要方法:
- 在中国兰西县的老年人 (>60岁) 中进行了一项大规模结核病查干预.
- 查包括问卷,体检,胸部放射 (CXR) 和进一步测试 (CT,涂抹,培养,Xpert) 寻找异常的CXR.
- 医疗保险覆盖范围被分类,以评估其对诊断的影响.
主要成果:
- 共有49339名老年人参与,占当地老年人口的32%.
- 查组的结核病患病率明显高于未查组的结核病患病率 (每10万人中233人),相比之下,未查组的结核病患病率明显高于每10万人中168人.
- 大规模查发现了50%的无症状结核病例,并且在基本医疗保险的人群中显著增加了检测.
结论:
- 在中国农村地区,基于人口的大规模结核病查,与常规检测相比,增加了44%的病例发现率.
- 该干预措施在识别无症状结核病病例和接触有限医疗保健机会的个人方面特别有效.
- 大规模查显示,通过在弱势群体中检测结核病,可以提高健康公平的潜力.
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