河北省1991~2001年涂阳肺结核病患者控制效果分析

Effects of directly observed treatment,short course strategy in the Health Ⅴ Programme 1991～2001 on tuberculosis control among smear positive patients in Hebei Province

目的通过对河北省世行贷款中国结核病控制项目(卫Ⅴ项目)实施结果进行分析,了解河北省实施结核病控制10年来的工作情况,评价直接督导下短程化疗(DOTS)策略实施效果。方法严格按照世行贷款中国结核病控制项目工作的实施计划和要求在全省11个市开展结核病控制工作,各项工作指标按照项目要求的患者季报表和月报表进行资料收集与统计。结果结核病控制工作效果显著,涂阳肺结核患者中青壮年所占比例较高,但呈逐年下降趋势,项目后期老年患者所占比例有所增加;近10年患者就诊与发现数量高于1990年以前,涂阳患者治愈率明显提高,达到95%以上,复治涂阳患者数量逐年减少。结论卫Ⅴ项目实施对推动河北省结核病控制工作效果显著,DOTS策略是保证患者发现和治愈的关键,DOTS策略的实施行之有效。

Objective To analyze the effects of the directly observed treatment, short course （DOTS） strategy in the Health Ⅴ Programme 1991-2001 funded by the World Bank on the tuberculosis （TB） control among smear positive patients in Hebei province. Methods The specific work plan was strictly implemented in 11 cities in Hebei Province. The data in the monthly and quarterly reports were collected and analyzed. Results The proportion of newly discovered smear positive TB patients aged 15-54 decreased slowly in these 10 years. The proportion in 2001 was 68.00%, remarkably lower than that in 1991 （76.50%） （P〉0.05）. The proportion in 2001 was 28.70%, higher than that in 1991 （22.30%）, The cure rat was 98.3% and the mortality rate was 0.62%. The treatment completion rate in 2000 was 〈0.01 %, significantly lower than that in 1992 （0.28%）. The ratio of first treatment to re-treatment of smear positive patients was 1：1.75 in 5 pilot counties in 1992, and decreased to 1：0.28 in 2001. Conclusion The DOTS strategy in the Health Ⅴ Programme 1991-2001 funded by the World Bank is effective in the TB control among smear positive patients in Hebei Province.