关键词: 结核, 肺, 学生, 延误就诊, 结果评价(卫生保健)

Abstract:

Objective To understand characteristics of the delayed visting in the students’ patients with tuberculosis, and to provide reference for further promoting the prevention and control of tuberculosis in schools.Methods The registration data of 586 students with pulmonary tuberculosis reported in our city from 2014 to 2018 were analyzed by descriptive epidemiological survey, and the influencing factors of delayed treatment were described in this study.Results Among 586 students with pulmonary tuberculosis in Mianyang City from 2014 to 2018, the delayed visting rate was 36.86% (216/586). The median days of delayed visiting (quartile) was 34 (8, 42)d. The delayed visiting rates of male and female were 34.36% (123/358) and 40.79% (93 /228), respectively. There was no significant difference statistically (χ ²=2.476,P=0.069). The delayed visiting rates of students with different academic qualifications were 39.13% (9/23) in primary school, 42.70% (38/89) in junior middle school, 35.08% (114/325) in general high school, 40.48% (17/42) in vocational high school, and 35.51% (38/107) in the university, respectively. There was no significant difference statistically (χ ²=2.117,P=0.714). The delayed visiting rate of local household registration students (38.45%, 193/502) was more higher than that of foreign household registration students (27.38%, 23/84) with significant difference (χ ²=3.266,P=0.043). The delayed visiting rate of students (36.86%) was lower than that of the whole population(58.80%, 10002/17009) with significant difference (χ ²=110.339,P=0.000). The delayed visiting rates of students were 45.98% (40/87), 40.48% (34/84), 40.13% (61/152), 30.06% (49/163) and 32.00% (32/100) during 2014 to 2018, respectively. The overall trend showed a downward trend ( {\chi }_{\mathrm{trend}}^2 =0.851,P=0.026). Among the methods of case finding, the delayed visiting rates of referrals, symptomatic visiting and follow-up were 38.78% (114/294), 41.72% (63/151) and 49.28% (34/69), respectively. There was no significant difference among the three methods (χ ²=2.586,P=0.274). However, the delayed visiting rate of patients found by physical examination (6.94%, 5/72) was lower than that of patients with referrals (χ ²=29.187,P=0.000).Conclusion Although the delayed visiting rate of students’ patients with tuberculosis in Mianyang City is lower than that of the whole population, the overall trend shows a downward trend. It needs to strengthen health education, especially to strengthen supervision and management for students of local household registration and students’ patients found by non-health physical examination.

Key words: Tuberculosis, pulmonary, Students, Delayed visiting, Outcome assessment(health care)