结核病非定点医疗机构肺结核漏诊及影响因素分析OA北大核心CSTPCD

Objective To understand the underdiagnosis of pulmonary tuberculosis(PTB)in non-designated TB medical institutions in 2022 and its influencing factors,providing a basis for further improving the quality of national tuberculosis(TB)prevention and control work.Methods Based on the cross-sectional survey data collected from National PTB Diagnosis and Report Quality Investigation in 2022,2 179 PTB cases diagnosed by 84 non-designated medical institutions and reviewed by expert groups were involved to analyze the diagnosis of pulmonary tuberculosis.Univariable and multivariable Logistic regression models were used to analyze the risk factors of underdiagnosis.Results Among 2 179 PTB patients,332 cases were not diagnosed as PTB(15.2％).Multiple Logistic regression analysis showed that non-tertiary medical institutions(OR=1.513,95％CI=1.156-1.980)、aged 0～＜15 years(OR=4.987,95％CI=1.790-13.888)、only cough(OR=1.818,95％CI=1.296-2.550)、single symptom(OR=1.984,95％CI=1.278-3.081)、with nagetive bacteriological results(OR=7.560,95％CI=3.931-14.540)、no bacterialogical results(OR=7.834,95％CI=4.151-14.785)、visitingas inpatients(OR=1.846,95％CI=1.403-2.429)were risk factors of underdiagnosis.Conclusions The proportion of underdiagnosis of PTB in non-designated medical institutions in China was high,and the occurrence of underdiagnosis was related to medical institutions,age,symptoms,pathogen results and treatment methods.Preventive activities should be formulated according to the above possible influencing factors to improve the quality of diagnosis.