全国结核病控制规划实施情况─—病人登记、管理及治疗

Implementation of National Tuberculosis Contrul Pro-gramme (focus on registratlon, case-managemeut andtrcatment)

我国三次结核病流行病学调查表明１９７９～１９９０年１１年间疫情下降缓慢。１９８２～１９９１年十年间的涂阳登记率及新登记率逐年上升至１９８８年达到高峰，表明病人发现及登记工作逐年改善。此后登记率逐年下降与患病率的下降趋势相一致。登记率占患病率的比例甚低，主要是由于大多数经非结防单位发现的病人未行登记。同时，全国已发现病人中只有１７．７％处于规律化疗管理之下。登记管理涂阳病人治疗结果队列分析表明痰菌阴转率逐年上升，丢失率逐年下降，治疗管理工作逐年改善。社会调查结果表明经济困难是治疗延迟、间断及中断治疗的主要原因之一。

he results of three nationwide epidemiological sur-veys on tuberculosis showed the declination of the mag-nitude of tuberculosis from 1979 to 1990 was slower.The case registration rates and new case registrationrates within ten years ( 1982～ 1991 ) were gradually in-creasing year by year and came to a climax in 1988. Thefact indicated the improvement of case-finding and caseregistration. The case registration rate was going downthereafter coincided with the declination of the preva-lence of tuberculosis. The proportion of registration rateto the prevalence was rather low. This is mainly at-tributed to the fact that the majority of detected patientswere held by general medical clinics and had not beenregistered to the central registration of tuberculosis.Therefore, only 17. 7% of detected tuberculosis caseswere under proper case-management for treatment. Theresults of cohort analysis on smear-positive treated casesshowed the rate of sputum negativeconversion wasgradually increasing and the case lost rate was goingdown. The case-management for tteatment was improv-ing year by year. The results of sociological study on tu-berculosis indicated that the financial problem was themain factor inducing delay of treatment and intermissionand interruption of treatment among treated patients.