湘西自治州实施现代结核病控制策略15年效果分析

Effect of Implementing Modern Strategies for TB Control for 15 Years in Xiangxi Autonomous Prefecture

目的分析湘西自治州实施现代结核病控制策略15年效果。方法收集并分析1992-2006年结核病项目工作报表及相关资料。结果15年共发现并免费治管活动性肺结核病人29989例,其中初治涂阳病人14120例,复治涂阳病人4535例,新发涂阴病人11334例。初治涂阳病人平均治愈率为92.2%,复治涂阳病人平均治愈率为86.3%,新发涂阴病人治疗成功率为96.5%。共计投入资金1313.87万元,平均发现并免费治疗和管理一例病人投入438.12元,减少了14200人因结核病死亡,使350000～524000名健康人免遭结核病的感染,产生的直接效益为2800万元,节约家庭直接成本为4900万元,产生的家庭直接效益为1.3亿元。全州新涂阳病人登记率由1993年的18.8/10万上升至2005年的64/10万,且历年来均高于湖南省平均值。结论现代结核病控制策略的推行,极大地促进并规范了湘西州结核病防治工作的实施,真正实现了结核病人高发现率和高治愈率的目标,取得了十分显著的社会效益和经济效益。但湘西州结核病高感染率导致高发病率的状况在短期内难以得到根本改变,只有继续推行并完善现代结核病控制策略,才能有效地控制结核病疫情。

Objective To analyze the effect of implementing the modern strategies for TB control for 15 years in Xiangxi Autonomous Prefecture. Method The TB project report forms and other related information from 1992 to 2006 were colleCted and analyzed. Results Over the past 1.5 years, there were 29,989 active pulmonary tuberculosis cases detected and received free treatment, including 14,120 new smear - positive cases, 4,53.5 retreatment smear - positive cases, and 11,334 new smear-negative cases. The average cure rate of new smear- positive cases was 92.2%. The average cure rate of retreatment smear - positive cases was 86.3 %. The successful cure rate of new smear - negative cases reached 96.5 %. Total direct input to the project was 1,313.87 ten thousand Yuan, the average cost for per case was 438.12 Yuan, reducing 14,200 cases died from TB; 350,000--524,000 healthy persons were prevented from being infected with TB, and the direct benefit was 2,800 ten thousand Yuan; saving direct cost of the household was 4,900 ten thousand Yuan, with the direct benefit of 130 million Yuan. In Xiangxi Autonomous Prefecture, the registered rate of new smear- positive TB increased annually from 18.8/100,000 in 1993 to 64/100,000 in 2005, and the registered rates during the period of 1992--2006 were all more than the average value in Hunan Province. Conclusions The modern strategies for TB control have greatly promoted and stipulated the TB control program, which are the effective measures to achieve the high case detection rate and the cure rate, and moreover, have got fair social profit and economic benefit. But there has been existing serious epidemic situation of TB because of the high infection rate of TB for a long history in Xiangxi Autonomous Prefecture, it is necessary to push on and improve the modern strategies for TB control so as to effectively control the epidemic situation of TB.