外出打工者肺结核病危险因素分析

目的 分析外出打工者肺结核病危险因素。方法 采用病例对照研究，选取51名近3年具有外出打工史的25～60岁的涂阳肺结核病人为病例组，同时从病例住所左右邻居中选取57名年龄在25～60岁之间、近3年有外出打工史的健康人作对照；制定统一的调查表进行入户调查；采用非条件Logistic回归进行分析。结果单因素分析显示，有统计学意义（P〈0．05）的因素有工作场所条件不舒适、每天工作时间较长（〉8h）、每周无休息日、不能按时吃饭，以及婚姻史中的单身、不良嗜好中的吸烟2个因素。其OR值分别为4．80，4．56。3．96。3．94，4．53，2．72；多因索分析进入模型的因素（P〈0．05）有工作场所条件不舒适、每天工作时间较长（〉8h）、每周无休息日以及婚姻史中的单身，其OR值分别为3．82．4．45，3．30，5．61。结论工作场所条件不舒适、每天工作时间超过8h、每周没有休息日是外出打工者肺结核病的危险因素；改善打工者的工作环境、维护打工者的合法休息时间，有助于保障外出打工者的身体健康及结核病疫情的控制。     

外出打工史与肺结核病发病联系的病例对照研究

[目的]探讨外出打工史与肺结核病发病的联系。[方法]采用病例对照研究,从结核病防治机构发现的肺结核人中选取160例25～60岁的涂阳肺结核病人作为病例,每个病例选取2名作为对照。[结果]160名肺结核病人与320名对照者有外出打工史的分别占46.9%、29.4%,二者差异具有统计学意义,OR值为2.4;近3年外出打工史分别占31.9%、17.8%,二者差异有统计学意义,OR值为2.4。采用多因素分析,控制了混杂因素后,外出打工史、近3年外出打工史的OR值仍为2.2、2.0。男性外出打工史、近3年外出打工史与肺结核发病显著性关联,其校正后的OR值分别为2.7、2.4。进一步采用多因素logistic回归模型分析,外出打工的工作场所条件不舒适、每天工作时间超过8h、每周没有休息日的OR值与95%CI分别为4.8（1.7～13.8）、4.9（1.5～16.0）、4.7（1.4～15.4）。[结论]男性外出打工与肺结核发病密切相联系,外出打工工作场所条件差,工作时间较长、每周没有休息日是农民外出打工发生肺结核的重要危险因素;女性外出打工与肺结核有无联系尚需进一步研究。     

江苏省农村居民结核病危险因素病例对照研究

目的　了解江苏省农村结核发病危险因素 ,为结核病控制提供依据。方法　采用 1∶1配对病例对照方法 ,分层整群抽取病例和对照各 318人进行问卷调查 ,计算OR值和 95 %CI ,并用条件Logistic回归模型进行多因素分析。结果　在单因素分析中 ,人均收入、住房类型、人均住居面积、膳食营养 (鸡蛋、肉类 )、劳动疲乏、经济负担重、有负性事件、结核相关疾病史、吸烟、有结核病 (TB)接触史等因素的OR值分别为 0 72 6 ,0 6 4 9,0 82 3,0 913,0 90 6 ,1 84 9,2 0 2 7,3 86 7,2 35 5 ,1 389,3 5 99;P均 <0 0 5。在多因素分析中 ,人均收入低、家庭经济负担重、劳动疲劳、有结核相关疾病史、有负性事件、有TB接触史是影响农村结核病的主要因素。结论　加强结核病人发现、治疗、管理 ,并针对其他危险因素采取控制措施对降低农村疫情有重要意义。     

嘉兴市中小学生肺结核危险因素病例对照研究

探索影响中小学生肺结核发病的主要危险因素,为开展学校肺结核病防控工作提供借鉴.方法 选择2008年1月至2009年12月间,嘉兴市中小学生中经结核病定点医院确诊的现患肺结核患者,进行1:1病例对照研究.结果 单因素分析中,体重、体质量指数、家庭经济条件、学习强度、文体活动强度、母亲文化程度、结核病接触史对中小学生结核患病的影响有统计学意义(P <0.05或P<0.01).多因素分析中,体质量指数<20 kg/m2(OR=8.406),家庭经济条件差(OR=5.781),学习强度大(OR=3.083),有结核病接触史(OR=13.698)是患肺结核病的危险因素;文体活动强度大(OR=0.385)和母亲文化程度高(OR=0.136)是保护因素.结论 中小学生结核病的患病危险因素复杂,自身抵抗力、家庭经济条件、结核病接触情况等与肺结核发病密切相关.     

慢性阻塞性肺疾病并发肺结核的影响因素

目的探讨慢性阻塞性肺疾病并发肺结核（COPD-PTB）的危险因素。方法采用以医院为基础的频数匹配病例对照研究方法,收集经确诊的105例COPD-PTB病例和105例对照的各项资料,采用单因素和多因素非条件logistic回归法筛选危险因素。结果单因素logistic回归分析显示,体重、文化程度、婚姻状况、职业、应激事件等15个变量影响COPD-PTB发病;多因素logistic回归分析显示,体重（OR=0.637）、文化程度（OR=0.654）、应激事件（OR=3.554）、结核病接触史（OR=3.187）、吸烟（OR=3.547）、接触粉尘史（OR=2.560）、取暖方式采用柴草土暖（OR=2.649）或者煤炉（OR=2.418）为COPD-PTB发病的重要影响因素。结论体重较轻、文化程度低、有应激事件、结核病接触史、吸烟、接触粉尘、柴草土暖或煤炉取暖等,是COPD-PTB发病的危险因素。     

河南省农村家庭经济条件与肺结核病之间的关系研究

目的：探讨农村家庭经济条件与肺结核发病的关系及在DOTS化疗管理、免费诊断和治疗策略下．肺结核对痛人家庭经济条件的影响。方法：首先．选取160例新发初治涂阳肺结核病人作为病例。每个病例选取2名与病例住所相邻、同性别和同年龄组的正常人作为对照组．采用发病前的家庭年收入与家庭财产2项指标衡量家庭经济条件。进行1：2配对病例对照研究；然后，对选取的所有病例进行随访收集有关费用；应用OR值及其95％的可信区间来估计其相对危险度：采用平均每例病人的家庭费用及其占家庭年收入的百分比来衡量结核病对家庭经济条件的影响。结果：160例肺结核病人发病前家庭年收入和家庭财产位于上等水平的分别占28．1％和25．6％．位于中等水平的分别占42．5％和35．6％，位于下等水平的分别占29．4％和38．8％，320例对照组同期的家庭年收入和家庭财产位于上等水平的分别占34．7％和37．2％．位于中等水平的分别占42．8％和33．1％。位于下等水平的分别占22．5％和29．7％：以上等水平作参照，单因素条件Logistie回归分析，家庭年收入的中等和下等OR值及其95％的可信区间分别为1．6（1．1-2．8）和2.3（1．2-4．4），家庭财产的中等和下等OR值及其95％的可信区间分别为1.7（1．1～2．8）和2．1（1.3～3．6），采用多因素条件Logistic回归分析后。家庭财产仍具有统计学意义，且OR值仍随着家庭经济条件水平的降低而增高，趋势性检验P值均小于0．05：肺结核病人家庭的直接费用平均为2772．0元．占平均病人家庭年收入的55．5％。我国结核病控制项目治疗下病人家庭的直接费用平均为2504．0元，占病人家庭年收入的50．1％：其他国家结核病控制项目治疗下病人家庭的直接费用平均为3360．0元，占病人家庭年收入的67.3％。结论：虽然，我国经济取得了快速发展．人民生活水平大幅度提高。但农村家庭经济条件差仍是肺结核病的重要危险因素．在实施DOTS策略及免费诊断和治疗策略下，肺结核病人家庭经济负担有所减轻，然而，肺结核病仍给病人家庭造成了沉重的经济负担．使原来本已贫困的家庭雪上加霜。     

西宁市居民结核发病危险因素病例对照研究

目的探讨影响西宁市结核病发病的危险因素,为预防和控制当地的结核病提供科学依据。方法从2005年1月至2007年1月在西宁市定点医院确诊的结核患者中单纯随机抽取120例符合选取标准的病例作为本次的病例组对象,另选180例非结核患者作为对照组进行病例对照研究,进行单因素和非条件Logistic回归多因素分析。结果单因素分析表明影响结核病发病的因素有：民族、文化程度、月人均收入、居室通风状况、吸烟史、运动锻炼、近5年吃水果类食品的情况、近5年吃动物类食品的情况、BCG接种史、TB接触史等。多因素分析结果提示：结核病的发病危险因素依次有（按贡献大小排列）：有结核病接触史、居室通风情况差、吸烟量多;结核病的发病保护因素有：近5年吃水果类食品多、文化程度高、有卡介苗接种史。结论影响结核病发病的因素较多,应及时发现并彻底治愈传染源,切断传播途径,保护易感人群,全面实现现代结核病控制策略,对降低当地的疫情有重要意义。     

滕州市农村青壮年肺结核发病危险因素的条件Logistic回归分析

目的探讨农村青壮年肺结核发病的危险冈素,为制订干预对策与措施提供依据。方法2011年7月至2012年12月,选取滕州市新发肺结核病人121例,按照1：1配对方法选择同一社区内与病例同性别、年龄±3岁,无严重呼吸系统疾患病史的人群为对照。进行影响肺结核患病因素的条件Logistic回归分析。结果在a=0．05的水平上,进入多因素条件Logistic回归模型的有8个因素,接种卡介苗可降低肺结核发病危险性,OR值为0．54;经济状况差、饮酒、结核病接触史、劳动疲乏、住房类别、体重指数、外出打工易患肺结核,OR值分别为3．68、1．67、1．99、2．87、1．87、2．06和2．87。结论经济状况差、饮酒、结核病接触史、劳动易疲乏、住房通风不好、体质偏瘦、外出打工是本地青壮年肺结核发生的主要危险因素,卡介苗接种是降低发病的保护性因素。     

滕州市农村青壮年肺结核发病危险因素病例对照分析

目的探讨滕州市农村青壮年肺结核发病的危险因素,为制订干预对策与措施提供依据。方法 2011年7月~2012年6月,选取滕州市新发肺结核病人102例进行1:1配对病例对照研究。结果 15个因素中,进入多因素条件Logistic回归模型的是经济状况、结核病接触史、劳动疲乏、住房类别、体重指数、外出打工和卡痕数7因素,OR值分别为3.13、2.06、3.06、1.68、2.06、2.86和0.56。结论有经济状况差、结核病接触史、劳动易于疲乏、住房通风不好、体质偏瘦、外出打工特征的人容易患肺结核,高质量卡介苗接种是降低发病的保护性因素。     

滕州市农村青壮年肺结核发病危险因素的条件logistic回归分析

目的探讨农村青壮年肺结核发病的危险因素,为制定干预对策与措施提供依据。方法2011年7月—2012年12月,选取滕州市新发肺结核患者121例,按照1：1配对方法选择同一社区内与病例同性别、年龄±3岁,无严重呼吸系统疾患病史的人群为对照。进行影响肺结核患病的条件logistic回归分析。结果在α=0．05的水平上,进人多因素条件logistic回归模型的有8个因素,即接种卡介苗可降低肺结核发病危险性,OR值为0．54;经济状况差、饮酒、结核病接触史、劳动疲乏、住房类别、体重指数、外出打工易患肺结核的OR值分别为3．68、1．67、1．99、2．87、1．87、2．56和2．97。结论经济状况差、饮酒、结核病接触史、劳动易疲乏、住房通风不好、体质偏瘦、外出打工是该市农村青壮年肺结核发生的主要危险因素,卡介苗接种是降低发病的保护性因素。     

Investigation of the risk factors for tuberculosis: a case-control study in three countries in West Africa

BACKGROUND: Host-related and environment-related factors have been shown to play a role in the development of tuberculosis (TB), but few studies were carried out to identify their respective roles in resource-poor countries. METHODS: A multicentre case-control study was conducted in Guinée, Guinea Bissau, and The Gambia, from January 1999 to March 2001. Cases were newly detected smear positive TB patients. Two controls were recruited for each case, one within the household of the case, and one in the community. RESULTS: Regarding host-related factors, univariate analysis by conditional logistic regression of 687 matched pairs of cases and household controls showed that TB was associated with male sex, family history of TB, absence of a BCG scar, smoking, alcohol, anaemia, HIV infection, and history and treatment of worm infection. In a multivariable model based on 601 matched pairs, male sex, family history of TB, smoking, and HIV infection were independent risk factors of TB. The investigation of environmental factors based on the comparison of 816 cases/community control pairs showed that the risk of TB was associated with single marital status, family history of TB, adult crowding, and renting the house. In a final model assessing the combined effect of host and environmental factors, TB was associated with male sex, HIV infection, smoking (with a dose-effect relationship), history of asthma, family history of TB, marital status, adult crowding, and renting the house. CONCLUSION: TB is a multifactorial disorder, in which environment interacts with host-related factors. This study provided useful information for the assessment of host and environmental factors of TB for the improvement of TB control activities in developing countries.     

遵义市中青年男性脑卒中患者吸烟行为特点及相关因素分析

目的 分析遵义地区中青年男性脑卒中患者吸烟行为特点及相关因素,为制定干预措施提供依据。方法 对2018年遵义市某医院就诊中青年男性吸烟脑卒中患者进行问卷调查,内容包括一般情况(文化程度、年龄、职业、婚姻状况、居住地)、吸烟情况(吸烟量、吸烟年限等)及尼古丁依赖程度量表,采用单、多因素分析方法对吸烟量影响因素进行分析。结果 共纳入120例中青年男性吸烟脑卒中患者参与本研究,年龄以40~59岁为主,占60.00%;职业以体力劳动为主,占58.33%;婚姻状况以已婚为主,占70.00%;尼古丁依赖程度以高度依赖为主,占45.00%;家庭收入情况以中等收入为主,占54.17%。人群平均吸烟量为(24.17 ± 4.01)支/d,其中轻度15例,中度32例,重度73例,分别占12.5%、26.7%、60.8%。多因素logistic回归模型分析结果显示,年龄越大(OR=6.044)、职业为体力劳动者(OR=3.935)、离异(OR=4.007)、尼古丁依赖程度越高(OR=6.913)的中青年男性脑卒中患者吸烟量越大,文化程度越高(OR=0.420)的中青年男性脑卒中患者吸烟量越小。结论 遵义地区中青年男性脑卒中患者吸烟量较大,年龄越大、体力劳动、离异、尼古丁依赖程度高是中青年男性脑卒中患者吸烟量的危险因素,相关部门可针对此人群特点制定相应的干预措施,以降低该人群脑卒中患病风险。     

Women's health status in Poland in the transition to a market economy

Since 1989 Poland has been experiencing large-scale social and economic changes as a result of the reforms associated with the transition to a market economy. This study uses a 1996 Health Survey of over 20,000 women to examine the impact of the new socio-economic situation and of women's multiple roles on their health at the early stage of transition. We investigated the importance of selected economic, socio-demographic and cultural determinants in explaining differences in women's health status in Poland, focusing on education level, (un)employment, living conditions, marital status, smoking and life style. There are health inequalities between men and women in Poland based on life expectancy, chronic diseases and health self-assessment. Some of these, especially the large differences between life expectancy at working ages, may be attributed to the difficult socio-economic situation. The multivariate analysis of women's self-assessed health and morbidity from selected chronic diseases indicated substantial inequalities in health. Together with the behavioural and cultural risk factors recognized by medicine, such as obesity, lack of physical exercise and smoking, the paper shows the crucial role of economic factors in influencing Polish women's health. Women whose financial position is poor are more likely to assess their health as less than good, to suffer from respiratory and circulatory systems' diseases and report neurotic problems. Other factors, strongly connected with the transition process in Poland, which contribute to health problems are lack of employment and low educational level, particularly for younger women. Women's marital and parental status are also important predictors of some categories of health problems; however, their influence varies for women of different ages. Our survey also supports the thesis that loneliness in old age, defined on the basis of living in a one-person household, may be negatively correlated with health status.     

Risk Factors for DOTS Treatment Default Among New HIV-TB Coinfected Patients in Nalgonda (Dist.) Telangana (State): A Case Control Study

Background:The therapeutic regimens as recommended by the Revised National TB Control Programme (RNTCP) have been shown to be highly effective for both preventing and treating tuberculosis, but poor adherence to medication is a major barrier to its global control.Results:The mean age was 36.5 ± 9 years; the majority (23.3%) of patients defaulted during the second month of treatment. Significant risk factors associated with defaulting included unskilled occupation [adjusted odds ratio (AOR: 3.56; 95% confidence interval (CI): 1.1-11.56], lower middle class socioeconomic status (AOR: 17.16; 95% CI: 3.93-74.82), small family size (AOR: 21.3; 95% CI: 6.4-70.91), marital disharmony (AOR: 6.78; 95% CI: 1.93-23.76), not being satisfied with the conduct of health personnel (AOR: 7.38; 95% CI: 2.32-23.39), smoking (AOR: 8.5; 95% CI: 2.31-31.21), and side effects of drugs (AOR: 4.18; 95% CI: 1.35-12.9).Conclusion:Unskilled occupation, marital disharmony, small family size, lower middle class socioeconomic status, not being satisfied with the conduct of health personnel, smoking, and drug side effects were significantly associated with defaulting. Information on the pattern of tuberculosis (TB), the outcome of anti-tuberculosis treatment (ATT), and the factors associated with it will help in planning interventions to improve adherence to DOTS treatment.     

Social Class, Race/Ethnicity and All-Cause Mortality in the US: Longitudinal Results from the 1986–1994 National Health Interview Survey

BACKGROUND: Occupational social class has become a leading indicator of social inequalities in health. In the US, economic sectors are distinct with respect to wages, benefits, job security, promotion ladders and working conditions. The growing economic sector of self-employed workers is characterized by lower wages and benefits, and greater job insecurity. Little attention has been given to the association between economic sector measures of social class and all-cause mortality, and there have been no studies of mortality among the self-employed. METHODS: To determine risk of death associated with economic sector social class, this study entails a longitudinal analysis of the National Health Interview Survey (NHIS), an annual household survey representative of the US population for the period 1986-1994 (n = 377,129). The sample includes 201,566 men and 175,563 women, aged 24-65 years of age, in the civilian labor force. RESULTS: Non- professionals are at higher risk of death than professionals across all sectors and self-employed professionals are at higher risk of death than professionals employed in government and production. Additional social class differences are accounted for by age, race, gender and marital status. Results are also partially explained by income. After controlling for income, Black professionals did not show a lower risk of death than Black non-professionals and self-employed Hispanic professionals had a higher risk of death than Hispanic professionals employed in the private sector. CONCLUSIONS: Given the growth of self-employment in the US, the noted increased risk of death among self-employed professionals merits further investigation and monitoring.     

苏南地区公众肺结核防治知识现状及其影响因素分析

目的 了解苏南地区公众肺结核防治知识现状及其影响因素,为有效开展肺结核健康教育提供依据。方法 采用逐级整群抽样调查,抽取苏南地区2个县、4个乡镇（街道）、12个村（居委会）的1200户,按照制定的调查对象入选标准,使用统一设计的调查问卷,共调查2179人,有效应答率为99.77%。结果 苏南地区公众肺结核防治知识总知晓率为23.03%。58.46%的调查对象知道肺结核一种以上主要症状,仅24.84%和24.56%的公众分别知道肺结核免费检查和免费治疗政策。居住地、户口性质、文化程度、保险形式、婚姻状况、职业、年龄、周围有无肺肺结核人、自身有无患过肺结核病、是否听过广播宣传肺结核、过去一年是否看过电视上肺结核相关知识节目、是否获得过防治结核宣传材料等12项因素对该地区公众知晓肺结核防治知识有影响。结论 苏南地区公众肺结核防治知识知晓率较低,尤其缺乏对肺结核症状知识和对国家相关免费政策的了解,针对该地区公众设计适合的肺结核健康教育方式势在必行。     

Longitudinal relationships among overweight, life satisfaction, and aspirations in young women

OBJECTIVE: This study investigated associations of overweight status and changes in overweight status over time with life satisfaction and future aspirations among a community sample of young women. RESEARCH METHODS AND PROCEDURES: A total of 7865 young women, initially 18 to 23 years of age, completed two surveys that were 4 years apart. These women provided data on their future life aspirations in the areas of further education, work/career, marital status, and children, as well as their satisfaction with achievements to date in a number of life domains. Women reported their height and weight and their sociodemographic characteristics, including current socioeconomic status (occupation). RESULTS: Young women's aspirations were cross-sectionally related to BMI category, such that obese women were less likely to aspire to further education, although this relationship seemed explained largely by current occupation. Even after adjusting for current occupation, young women who were obese were more dissatisfied with work/career/study, family relationships, partner relationships, and social activities. Weight status was also longitudinally associated with aspirations and life satisfaction. Women who were overweight or obese at both surveys were more likely than other women to aspire to "other" types of employment (including self-employed and unpaid work in the home) as opposed to full-time employment. They were also less likely to be satisfied with study or partner relationships. Women who resolved their overweight/obesity status were more likely to aspire to being childless than other women. DISCUSSION: These results suggest that being overweight/obese may have a lasting effect on young women's life satisfaction and their future life aspirations.     

Prevalence of obesity and associated risk factors in a Turkish population (trabzon city, Turkey)

OBJECTIVE: To estimate the prevalence of overweight and obesity (general and central) in the Trabzon Region and its associations with demographic factors (age, sex, marital status, reproductive history in women, and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, and obesity), lifestyle factors (smoking habits, physical activity, and alcohol consumption), and hypertension in the adult population. RESEARCH METHODS AND PROCEDURES: A sample of households was systematically selected from the central province of Trabzon and its five towns, namely, Sürmene, Vakfikebir, Ma?ka, Hayrat, and Tonya. A total of 5016 subjects (2728 women and 2288 men) were included in the study. Individuals more than 20 years old were selected from their family health cards. Demographic factors, socioeconomic factors, family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure and diastolic blood pressure levels were measured for all subjects. Study procedures were carried out in the local health centers in each town over an 8-month period. Obesity was defined as BMI > or = 30 kg/m2 and overweight as BMI = 25.0 to 29.9 kg/m2. RESULTS: The prevalence of obesity was 23.5%: 29.4% in women and 16.5% in men. The combined prevalence of both overweight and obesity was 60.3%. The prevalence of abdominal obesity was 29.4%: 38.9% among women and 18.1% among men. The prevalence of obesity increased with age, being highest in the 60- to 69-year-old age group (40.8%) but lower again in the 70+ age group. Obesity was associated positively with marital status, parity, cessation of cigarette smoking, alcohol consumption, and household income and inversely with level of education, cigarette use, and physical activity. Also, obesity was associated positively with hypertension. DISCUSSION: In the Trabzon Region, 60.3% of the adult population presents with some excess weight. Obesity is a major public health problem that requires generalized interventions to prevent it among the adult population.     

综合医院住院结核病患者特征与治疗转归的对应分析

目的 了解中国综合医院结核病住院病例的治疗效果，探索不同属性特征的结核病患者住院期间的治疗转归。方法 对南充地区综合医院2003年结核病住院病例进行回顾性研究，采用x^2检验确定对住院转归具有统计学意义的属性变量，在此基础上，再采用对应分析方法揭示结核病患者不同属性特征与不同住院转归之间的内在联系。结果 x^2检验结果显示，住院结核病例的性别、年龄、入院时病情、伴随病（其他疾病或并发症）及住院天数对住院转归具有统计学意义；对应分析图进一步显示患者属性特征与住院转归的关系：（1）住院期间死亡的结核病患者与治愈、好转的结核病例属性特征差别较大；（2）年龄在15岁以上、入院时病情急的男性结核病患者住院期间容易出现好转的治疗结局；（3）入院时病情一般、没有伴随病、住院时间超过8天的女性：结核病例相对容易出现治愈的结局；（4）住院治疗效果较差的结核病例在年龄〈15岁、入院病情危重两方面表现出一定的一致性。结论 （1）如何从病案繁杂的信息中提取出有用的信息，对应分析提供了一种新的思路；（2）综合医院结核住院患者特征与住院转归间存在一定的对应关系，应针对不同特征的结核住院患者制定相应的防治策略，以强化完成抗结核病治疗提高治愈率。