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目的分析重庆市结核病信息管理系统(专报)中的儿童结核病登记质量、现状及原因。方法检索专报中登记的0~14岁儿童结核病资料,进行统计分析和现场调查,内容包括:数据预分析、现场核查、问卷调查和定性访谈。结果 2009—2015年重庆市共登记了1 388例0~14岁结核病患儿中,9.4%的患者录入错误,排除70例年龄超过14岁和诊断变更的病案,实际登记1 318例中以10~14岁为主(86.4%)。问卷调查显示,疾控机构确诊10~14岁患儿的比例为64.8%,高于0~9岁患儿的18.2%,差异有统计学意义(P<0.01);定性访谈提示,疾控机构医生能利用现有的诊断工具和经验对10~14岁患儿进行诊断并登记,而对0~9岁患儿多转诊,可能漏诊,仅通过综合医院疫情报告获得信息,追踪难度较大,可能漏登。结论重庆市儿童结核病登记质量有待提高,登记可能不全,不能反映真实疫情,应加强医防合作,提高儿童结核病的登记率。
Objective To analyze the quality, current status and causes of tuberculosis registration among children in Chongqing tuberculosis information management system (special report). Methods The tuberculosis data of children aged 0-14 years registered in the special report were searched for statistical analysis and on-the-spot investigation. The contents include: data pre-analysis, field verification, questionnaire survey and qualitative interview. Results In 2009-2015, a total of 1 388 children aged 0-14 years with tuberculosis were enrolled in Chongqing. 9.4% of the patients were mistyped and excluded 70 cases of patients aged over 14 years and diagnosed with changes. The actual registration of 1 318 cases was 10 ~ 14 years old (86.4%). The questionnaire survey showed that the proportion of children aged 10-14 years old who were confirmed by CDC was 64.8%, which was higher than that of children aged 0-9 years (18.2%) (P <0.01). The qualitative interview indicated that CDC Doctors can use existing diagnostic tools and experience to diagnose and register children aged 10 to 14 years and may misdiagnose more patients aged 0 to 9 years and may obtain information through comprehensive hospital outbreak reports and find it more difficult to trace , May be missed. Conclusion The quality of children’s TB registration in Chongqing needs to be improved. Registration may not be complete and the actual epidemic situation can not be reflected. Medical and drug cooperation should be strengthened to increase the registration rate of children’s tuberculosis.