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目的分析广西4个县传染病报告信息管理系统(大疫情)与结核病信息管理系统(专报)分别报告和登记的肺结核患者数据的不一致率以及原因。方法选择两系统分别导出的报告与登记数差异较大的A、B、C、D 4个县进行现场核查和统计分析。内容包括:数据预分析、定性访谈、现场核查和抽样调查。结果两系统的平均报告登记一致率为32.45%,最低17.09%。疑似肺结核患者被排除后没有从专报向大疫情推送占65.41%;专报82例转诊到位未收治和未排除的疑似肺结核病例,其中15例(18.29%)为流动治疗患者,实则并未到位及登记;5例(6.10%)无诊疗资料;62例有资料者中,9例(14.52%)涂阳肺结核患者没有得到收治,10例(16.13%)既往有抗结核治疗史的涂阴肺结核病患者由于无法定性,未得到及时处理,其余43例到位后均未进行收治或排除;抽查40例排除活动性肺结核病例的排除符合率为67.50%。结论专报系统排除活动性肺结核患者数据没有向大疫情推送,是导致两个系统报告和登记数据不一致的主要原因;结防机构过度排除患者成为疫情丢失的隐患;到位未收治或未排除体现了部分基层结防机构工作责任心和积极性不足;流动治疗患者及既往有抗结核治疗史涂阴肺结核患者的管理、收治是目前专报系统登记和管理的空白区。应加强基层人员能力建设,建立和优化两系统报告与登记数据质量定期核查机制。
Objective To analyze the inconsistency rate of tuberculosis patients data reported and registered by TB information management system (major epidemic situation) and tuberculosis information management system (special report) in 4 counties of Guangxi and their causes. Methods The reports of the two systems and the four counties A, B, C and D with large differences in registrations were selected for site verification and statistical analysis. Content includes: data pre-analysis, qualitative interview, on-site verification and sample survey. Results The average registration consistency of the two systems was 32.45% and the lowest was 17.09%. Suspected tuberculosis patients were excluded from the special report to the large epidemic situation accounted for 65.41%; reported 82 cases referral in place not treated and not suspected cases of suspected pulmonary tuberculosis, of which 15 cases (18.29%) for mobile treatment patients, but not actually 9 cases (14.52%) had smear-positive pulmonary tuberculosis patients were not treated, 10 cases (16.13%) had a past history of anti-TB treatment of smear Tuberculosis patients were not qualified because of not being treated promptly, and the remaining 43 cases were not treated or excluded after they were in place. The exclusionary rate of 40 cases excluding active tuberculosis was 67.50%. Conclusion The special report system to exclude active tuberculosis patient data was not sent to the major epidemic situation, which led to the two systems reporting and registration data is the main reason for inconsistencies; over-exclusion of patients as a hidden danger of epidemic outbreak; unrecognized in place or not excluded Part of the work of grass-roots prevention and treatment agencies with a sense of responsibility and lack of enthusiasm; flow treatment of patients and history of anti-tuberculosis treatment of smear-negative tuberculosis patients management, treatment is currently a special area of registration and management of the system blank. The grassroots personnel should strengthen their capacity building and establish and optimize a periodic verification mechanism for the reporting and registration data quality of the two systems.