黔南州结核病传染源调查研究

The investigation of the tuberculosis infectious source in Qiannan prefecture state

目的 探索结核病传染源的发现方法 ,了解其分布 ,为制定结核病控制措施提供科学依据。方法 选择 1 2个县市中的 8个县为调查点 ,余 4个县为对照点。调查点与对照点县疾控中心设结核防治组 ,负责可疑结核病例的痰检 ,对胸片或胸透异常及有可疑结核病症状者 ,进行痰涂片检查。调查点工作内容除病例痰检免费、涂阳病例免费治疗外与对照相同。结果 调查点肺结核报告病例痰检率 5 1 .1 %,涂阳年登记率 2 5 .99/ 1 0万 ,对照点肺结核痰检率 1 8.3%,涂阳病例年登记率 0 .2 6 /1 0万 ;临床首诊为支气管炎、肺部感染和其他痰病病例中结核菌检出率分别为 1 2 .4 %、1 1 .8%、8.2 %。结论 农村结核感染形势严峻 ,政府应加大投入 ,对农村现阶段应免费痰检 ,涂阳病例免费治疗 ,医疗单位应将结核菌痰检作为呼吸系统疾病的常规检验项目 ,以及早发现传染源。

Objective To seek for the methods for detecting the tuberculosis infectious source and determine its distribution for providing the scientific evidences for developing measures for tuberculosis control.Methods Selecting 8 out of 12 counties as the investigated areas,while the others are taken as the control ones.The tuberculosis control teams were established in county CDC that were responsible for providing smear examination for the TB suspects.The township hospitals were responsible for health education,sputum collection.The working approaches in investigation areas and control areas were the same except free smear examination and free treatment policy in investigation areas.Results The rate of the sputum smear examination in the investigated areas was 51.1%.The notification rate of smear positive cases was 25.99/100?000.It was 18.3% and 0.26/100?000 accordingly in the control areas.The smear positive detected rate in the patients that diagnosed as bronchitis,lung infection,and others was 12.4%,11.8%,8.2% respectively.There was no difference in the location distribution and seasons distribution of cases.There was a higher infection rate among peasants and youth.Conclusion The situation of TB infection in rural area was serious.The governments should provide more funds for TB control and to implement free smear examination and free treatment for smear positive cases.In order to find infectious TB sources as soon as possible,smear examination should be one of the routine test in hospitals for respiratory diseases.