Abstract:

Objective　To evaluate the delay of tuberculosis treatment in Chinese students. Methods　CNKI, Web of Science, Wanfang Data, Pubmed, SinoMed, VIP, and The Cochrane Library were searched for the cross-sectional studies on the delayed rate of tuberculosis treatment in Chinese students from January 2000 to July 2022. Stata 17.0 was used for the meta-analysis. Results　A total of 57 cross-sectional studies were included, including 67 105 subjects and 39 831 students with delayed treatment of pulmonary tuberculosis. Meta-analysis showed that the delayed rate of tuberculosis treatment in the Chinese students was 47.8% (95%CI 47.6%-48.1%) (P<0.001). The results of subgroup analysis showed that the delayed rates of the male and female students were 50.0% and 50.7%, respectively; the delayed rates of the students who were in primary school and below, middle school, high school, and college and above were 43.2%, 46.1%, 46.1%, and 46.0%, respectively; the delayed rates of the students from the eastern, southeastern, central, southwestern, southern, and northern regions were 43.7%, 44.1%, 37.8%, 50.5%, 54.7%, and 50.5%, respectively; the delayed rates of the local and non-local students were 51.9% and 50.6%, respectively; the delayed rates of the students discovered by medical treatment or recommendation, health examination, referral, follow-up, and other methods were 46.3%, 44.4%, 50.7%, 53.6%, and 35.7%, respectively; the delayed rates of the students taking initial treatment and retreatment were 52.9% and 46.3%, respectively; the delayed rates of the students with negative and positive pulmonary tuberculosis were 46.0% and 52.4%, respectively; the delayed rates in the first, second, third, and fourth quarters were 41.6%, 37.5%, 34.7%, and 37.6%, respectively; the delayed rate of treatment published between 2000 and 2010 was not included due to the low quality and small number of relevant literatures, and the delay rates from 2011 to 2015 and from 2016 to 2021 were 46.9% and 44.4%, respectively; the delayed rates of the Han and minority groups were 77.4% and 54.9%, respectively. Conclusions　The delayed rate of medical treatment of students with pulmonary tuberculosis in China has slightly decreased in recent 10 years, but the overall rate is still high. The delayed rate of tuberculosis treatment in Chinese students is affected by gender, region, household registration, education background, quarter, ethnicity, and other factors.

Key words:

Pulmonary tuberculosis, China, Students, Delayed consultation, Cross-sectional study, Meta-analysis

摘要：

目的　系统评价中国学生肺结核的就诊延迟情况。方法　检索知网、Web of Science、万方、Pubmed、SinoMed、维普、The Cochrane Library数据库，搜集中国学生肺结核就诊延迟率的横断面研究文献。检索时限2000年1月至2022年7月，使用Stata 17.0进行meta分析。结果　共纳入57个横断面研究，67 105例研究对象，39 831例学生肺结核就诊延迟患者，中国学生肺结核就诊延迟率的meta分析结果为47.8%（95%CI 47.6%～48.1%）（P<0.001）；亚组分析结果显示，中国学生男性、女性肺结核患者就诊延迟率分别为50.0%、50.7%；小学及以下、初中、高中、大学及以上的患者就诊延迟率分别为43.2%、46.1%、46.1%和46.0%；东部、东南部、中部、西南部、南部和北部地区患者就诊延迟率分别为43.7%、44.1%、37.8%、50.5%、54.7%、50.5%；户籍本地、外地患者就诊延迟率分别为51.9%、50.6%；因症就诊或推荐、健康体检、转诊、追踪和其他发现方式患者就诊延迟率分别为46.3%、44.4%、50.7%、53.6%和35.7%；初治患者就诊延迟率为52.9%，复治患者就诊延迟率为46.3%；病原学检查阴性和阳性患者就诊延迟率分别为46.0%和52.4%；第1季度、第2季度、第3季度、第4季度就诊延迟率分别为41.6%、37.5%、34.7%和37.6%；发表时间在2000—2010年的就诊延迟率因相关文献质量不高、数量少未收录，2011—2015和2016—2021年就诊延迟率分别为46.9%、44.4%；汉族和少数民族就诊延迟率分别为77.4%和54.9%。结论　中国学生肺结核患者就诊延迟率近10年略呈下降趋势，但总体仍然较高，受性别、地区、户籍、发现方式、学历、季度、民族等因素的影响。

关键词:

肺结核, 中国, 学生, 就诊延迟, 横断面研究, meta分析