建立农村地区结核病防治体系控制肺结核流行的效果

Evaluation of results of mesures in control of prevalence of tuberculosis in rural areas of Gansu Province

目的探讨建立农村地区结核病防治体系控制肺结核流行的技术策略,为政府决策提供科学依据。方法通过世行贷款/英国赠款、全球基金及FIDELIS三个结核病控制项目的实施,筛选科学有效的肺结核防治策略,回顾性分析预防控制效果以检验其可行性。结果全市肺结核免费筛查范围扩大3.3倍,医疗机构疑似病人报告率提高31.3%,全人口初诊病人就诊率提高202%,新涂阳肺结核病人发现率由33.3%提高到72.2%,新涂阳病人2月末痰菌阴转率由88.7%提高到93.8%,治愈率由84.1%提高到92.7%;肺结核病人就诊延迟率由71.7%下降至40.0%,治疗中断率由9.1%下降至4.2%,农村群众结核病防治知识知晓率由31.2%提高到65.6%,每年可保护健康人群5.38万人,7年累计减少肺结核病人37660人。结论坚持一个原则,建立一个机制,加强一个建设,落实一个保障,健全一个网络,实施一个规范,推行四大策略的农村地区结核病防治体系和工作模式,预防控制效果良好,社会效益显著,对实现结核病防治规划目标,提高整体工作质量有明显推动作用。

Aim To evalute the results of measures of tuberculosis control in rural areas of Gansu Province.Methods After implementation o World Bank Loan /British Donation fund,Global TB fund and FIDELIS,The mesures of tuberculosis control in rural areas of Gansu were analyzed.Results The reporting rate of suspected tuculosis cases inceased by 31.3%,the first diagnostic rate medical institutions increaed by 202%,,the discovery rate of new smear positive cases was 72.2%,the negative concersion rate of new smear positives was 93.8%,the cure rate reached 92.7%,the timely diagnostic rate also rose and treatment interruption rate reduced to 4.2%,the tuberculosis knowledge reached 65.6% and 37 660 tuberculosis infections were prevented.Conclusion The measures of tuberculosis control conducted in Gansu are effective