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目的了解影响艾滋病(AIDS)病例发现及时率的相关因素。方法通过对广东省某市2012年1月1日至2013年9月30日报告病例的分析,了解可能影响病例发现及时率的相关因素(不包括感染者本人的主观因素)。结果此间报告的489例艾滋病病毒(HIV)感染者和AIDS病人中,有37.6%(184/489)发现不及时。异性性传播的HIV感染者发现不及时的比例,显著高于其他途径感染者(χ2=21.53,P<0.01);医院报告的病例及时率低于疾病预防控制中心、羁押场所及血站等其他单位[比值比(OR)=0.42,95%可信区间(CI):0.28~0.64,P<0.01]报告的病例;主动提供检测发现病例的及时率显著高于接受被动检测发现的病例(OR=3.17,95%CI:2.17~4.65,P<0.01)。Logistic多因素分析发现,仅监测类型对病例发现及时率构成影响(OR=2.91,95%CI:1.67~5.04,P<0.01)。结论积极为各种高危人群提供主动检测,是提高病例发现及时率的重要手段和方法,主动检测的重点人群应该以可能发生异性性传播的人群为主。
Objective To understand the factors influencing the timeliness of AIDS cases. Methods To analyze the reported cases from January 1, 2012 to September 30, 2013 in a certain city of Guangdong Province to understand the relevant factors (excluding the subjective factors of infected persons) that may affect the prompt rate of case finding. As a result, 37.6% (184/489) of 489 HIV-infected and AIDS patients reported here were found not to be timely. The proportion of patients with HIV transmitted by heterosexual transmission was found to be significantly lower than those of other HIV infected patients (χ2 = 21.53, P <0.01). The rate of reported cases in hospitals was lower than that of other centers such as CDC, prisons and blood banks (OR = 0.42, 95% confidence interval (CI): 0.28-0.64, P <0.01]. The rate of promptly providing detected cases was significantly higher than that of patients receiving passive testing (OR = 3.17, 95% CI: 2.17 ~ 4.65, P <0.01). Logistic multivariate analysis showed that only the type of surveillance had an impact on the rate of prompt diagnosis (OR = 2.91, 95% CI: 1.67-5.04, P <0.01). Conclusion Active testing for all kinds of high risk groups is an important method and method to improve the rate of timely detection of cases. The key groups that should be actively tested should be mainly those who may have heterosexual transmission.