结核与肺部疾病杂志 ›› 2021, Vol. 2 ›› Issue (4): 340-346.doi: 10.3969/j.issn.2096-8493.20210096

• 论著 • 上一篇    下一篇

养老机构老年人结核病筛查及核心知识知晓情况调查

方兰君, 吴惠忠, 周芳静, 苏静, 温文沛, 周琳, 陈亮()   

  1. 510630 广州,广东省结核病控制中心
  • 出版日期:2021-12-30 发布日期:2022-01-06
  • 通信作者: 陈亮 E-mail:568323856@qq.com
  • 基金资助:
    “十三五”国家科技重大专项(2018ZX10715004-002);广东省医学科学技术研究基金(C2019073)

Investigation of tuberculosis screening and core knowledge among elderly people in elderly care institutions

FANG Lan-jun, WU Hui-zhong, ZHOU Fang-jing, SU Jing, WEN Wen-pei, ZHOU Lin, CHEN Liang()   

  1. Centre for Tuberculosis Control of Guangdong Province, Guangzhou 510630, China
  • Online:2021-12-30 Published:2022-01-06
  • Contact: CHEN Liang E-mail:568323856@qq.com

摘要:

目的 掌握养老机构老年人结核病筛查及核心知识知晓情况。方法 采取整群随机抽样的方法,于2019年10月至2020年12月从广东省的广州、深圳、清远等3个城市抽取4家养老机构进行研究,其中,公办和民营各2家;选取于养老机构内入住,年龄≥60岁,未出现意识模糊或相关重大疾病,可正常沟通并同时接受结核病筛查和问卷调查的老年人作为研究对象,最终纳入178名。采用调查问卷收集研究对象社会人口学信息、肺结核可疑症状、病史、体检情况,以及结核病防治核心知识知晓情况等。采用症状筛查和拍胸部X线摄片(简称“胸片”)进行结核病筛查,对有肺结核可疑症状或胸片异常阴影者,通过痰涂片和培养、GeneXpert MTB/RIF及胸部CT扫描等进行确诊或排除肺结核。分析研究对象健康状况、体检情况,以及结核病筛查情况和结核病防治核心知识知晓情况。结果 178名研究对象中,1例确诊为活动性肺结核(病原学阳性),活动性肺结核患病率为561.80/10万。研究对象中85.39%(152/178)有慢性基础疾病;近1年进行了体检的142名中,进行了胸片检查的比例为33.80%(48/142),民营养老机构研究对象进行胸片检查的比例(60.61%,20/33)高于公办养老机构(25.69%,28/109),差异有统计学意义(χ2=13.803,P<0.001)。研究对象结核病防治核心知识总知晓率为43.35%(463/1068);民营养老机构研究对象的总知晓率(53.88%,139/258)明显高于公办养老机构(40.00%,324/810),差异有统计学意义(χ2=15.341,P<0.001)。结论 养老机构老年人活动性肺结核患病率高,结核病筛查率和防治核心知识知晓率低,应将养老机构老年人作为结核病防控重点人群,持续有效开展健康教育,定期进行肺结核主动筛查,做到早期发现肺结核患者。

关键词: 结核,肺, 老年人, 问卷调查, 健康知识

Abstract:

Objective To investigate the status of tuberculosis screening and core knowledge awareness among the elderly in elderly care institutions. Methods By cluster random sampling, four elderly care institutions were selected from Guangzhou, Shenzhen and Qingyuan in Guangdong Province from October 2019 to December 2020, including two public and two private institutions. A total of 178 subjects admitted to elderly care institutions without blurred consciousness or related major diseases were enrolled in this study, all of them aged ≥60 years, could communicate normally, and received tuberculosis screening and questionnaire survey. Questionnaires were used to collect sociodemographic information, suspicious symptoms of tuberculosis, history, physical examination, and awareness of tuberculosis prevention and control knowledge. Symptom screening and chest X-ray were used for tuberculosis screening, and tuberculosis was confirmed or excluded by sputum smear and culture, GeneXpert MTB/RIF and chest CT for those with suspicious symptoms of tuberculosis or abnormal shadow on chest X-ray. The health status, physical examination status, tuberculosis screening status and knowledge of core knowledge of tuberculosis prevention and treatment were analyzed. Results Among the 178 subjects, one case was diagnosed as active pulmonary tuberculosis (positive in etiology), and the prevalence of active pulmonary tuberculosis was 561.80/100000; 85.39% (152/178) had chronic diseases. Among the 142 people who underwent physical examination in the past year, the proportion of chest X-ray examination was 33.80% (48/142). The proportion of chest X-ray examination of private elderly care institutions (60.61%, 20/33) was significantly higher than that of public elderly care institutions (25.69%, 28/109) (χ2=13.803, P<0.001). The total awareness rate of core knowledge of tuberculosis prevention and treatment was 43.35% (463/1068). The total awareness rate of private elderly care institutions (53.88%, 139/258) was significantly higher than that of public elderly care institutions (40.00%, 324/810) (χ2=15.341, P<0.001). Conclusion The prevalence of active tuberculosis among the elderly in elderly care institutions was high, and the tuberculosis screening rate and core knowledge of prevention and control were low. Therefore, the elderly in elderly care institutions should be regarded as the key population of tuberculosis prevention and control, health education should be carried out continuously and effectively, and active tuberculosis screening should be carried out regularly, to detect pulmonary tuberculosis patients early.

Key words: Tuberculosis,pulmonary, Aged, Questionnaires, Health knowledge