外来人口结核病流行特征及管理效果评价

Epidemic characteristics of tuberculosis (TB) and evaluation on effectiveness of management among floating people

目的探讨深圳市外来人口结核病纳入结核病控制项目管理,寻找有效的管理治疗模式,以提高结核病控制效果。方法采取回顾性方法,将1993~1997年未进行外来人口结核病控制项目管理及1998~2004年实行了外来人口结核病控制项目管理进行对比研究。结果外来人口占新发涂阳肺结核的53.5%,新发涂阳肺结核病人年龄高峰期为20~30岁,男性患者是女性患者的2.153倍。涂阳肺结核病人职业构成为工人、商业服务、待业等。外来人口结核病控制项目实施前后报告数及转诊数均由9 727例上升到61 653例,转诊到位率由63.5%上升到90.2%。1993~2004年外来人口可疑肺结核病人4 845例,占69.5%;实施外来人口结核病项目管理前后的全程督导率分别为79.1%,95.6%,全程管理率分别为62.6%,96.2%;2月末痰菌阴转率由63.3%提高到84.6%,3月末痰菌阴转率由71.9%提高到92.2%;外来人口未纳入项目前涂阳肺结核治愈率仅为87.2%,纳入项目后治愈率提高到97.2%。结论对外来人口实施结核病项目的管理模式,加强健康教育与宣传等,治愈率不断提高,提高了深圳市的结核病控制效果。

Objective To explore bringing floating people into the management for TB control so as to find the effective model for decreasing the TB prevalence and increasing the cure rate, to improve the effectiveness of TB control within the whole city. Methods Retrospective comparison method was adopted. TB control management between 1993 -- 1997 and 1998--2004 was compared. Results The 53.5 percent of new sputum testing positive patients were from floating people. The percentage of patients aged 20 to 30 was the highest, the male was 2. 153 times of the female. The occupation of the positive patients included factory workers, commercial service workers and the unemployed. After complementing TB cntrolling for floating people, the number of transfer increased from 9 727 to 61 653, and the accomplishment rate of transfer increased from 63.5 percent to 90.2 percent. From 1993 to 2004, 88 798 of floating people were doubted with TB, the percentage was 80.62 percent. Among them 9 496 were with sputum testing positives and 4 845 were negatives （69.5 % ）. The complete su- pervising rate were 79.1% and 95.6 %. The complete management rate were 62.6 % and 96.2 %. The differences were sta- tistically significant （ P 〈 0.05 ）. At the end of 2 months of treatment, the negative rate changed from positive rate increased from 63.3 % to 84.6 % and at the end of 3 months, from 71.9 % to 92.2 %. Before floating people were brought project, the cure rate was only 87.2 %, however, the cure rate for positive TB patients was reached to 97.2 % after being brought into the project. Conclusion After establishing the mechanism of supervision and evaluation, bringing floating people into the TB controlling project, strengthening health education and propagandizing, the TB prevalence rate decreased yearly, the cure rate increased constantly, and the effectiveness of TB controlling was improved in Shenzhen city.