湖南省四次结核病流行病学抽样调查结果评价

Analysis and Evaluation on Result of the 4 National Tuberculosis Epidemiological Sampling Survey in Hunan Province

目的 从湖南省四次结核病流行病学抽样调查 (流调 )结果分析和评价我省结核病控制工作质量。 方法 对湖南省 1979、1985、1990和 2 0 0 0年四次全国结核病流调资料进行分析。 结果 前三次流调全省肺结核患病率、涂阳患病率和结核病死亡率均高于全国平均水平。 1979～ 1990年患病率和涂阳患病率年平均递降率分别为 0 77%和1 82 %。 2 0 0 0年流调全省患病率为 310 /10万 ,涂阳患病率为 10 7/10万 ,1990年～ 2 0 0 0年年平均递降率分别为 8 6 3%和5 0 2 % ,且涂阳患病率低于全国平均水平。四次调查除 1990和 1979年涂阳患病率外 ,农村患病率和涂阳患病率高于城市 (镇 )。且前三次流调农村患病率和涂阳患病率湖区 (平原 )明显高于丘陵和山区。 2 0 0 0年流调以山区居高。各次调查肺结核病人的发现均以新发病人为主 ,占 5 6 0 %～ 73 1%。已知病人中复治病人比例自 1985年始有所下降 ,但下降缓慢。 结论 近 10年全省结核病疫情的快速下降 ,显示了全省全面实施现代结核病控制策略的成效。但是农村患病率高 ,且以湖区 (平原 )转向山区患病率高的地域特征 ,以及新发病人比例高 ,复治病人比例下降缓慢等结核病现状 。

Objective To analyze and evaluate the result of 4 times tuberculosis epidemiological sampling survey in Hunan Province. Methods The information coming from 4 times national tuberculosis epidemiological sampling survey in Hunan Province in 1979、1985、1990 and 2000 were analyzed. Result Prevalence rate,smear-positive prevalence rate and mortality of pulmonary tuberculosis during the first 3 times survey in respectively higher than the national average prevalence rate,smear-positive prevalence rate,and mortality of pulmonary tuberculosis level.From 1979 to 1990,the prevalence rate and smear-positive prevalence reduced annually by 0.77% and 1.82% respectively.Survey in 2000, the prevalence rate is 310/100,000,smear-positive prevalence rate is 107/100,000 reduces respectively by 59.4% and 40.2% compared with that of 1990. The average annual reduction rate was 8.63% and 5.02%, and the smear-positive prevalence rate was lower than the national average level. Expect for smear-positive prevalence rate in 1979 and 1990, the prevalence rate and smear-positive prevalence rate in rural area were higher than urban(town) area during 4 time's survey. And during the first 3 time's survey,Prevalence rate and smear-positive prevalence rate in lake areas were higher than that in mountainous.Each survey shows that the new cases rate is high from 56.0% to 73.1%.The re-treatment cases reduced lowly in the known cases. Conclusion The great decrease of tuberculosis prevalence in the ten years later substantially indicates the efficacy of implementing modern tuberculosis control strategy in the Province.While the epidemic feature that the inadequate case detection, high re-treatment case rate and high prevalence rate in mountainous area are waiting to be studied.