四川省成都市入户调查集中推荐可疑症状者检查发现肺结核患者分析

Analysis of case detection of pulmonary tuberculosis patients through large-scale household survey and concentrated recommendation of tuberculosis suspects in Chengdu

目的探讨入户调查、集中推荐发现病人方式对提高肺结核病人发现的作用。方法采取政府组织、部门参与、开展健康教育,发动群众自报互报;镇村干部配合、乡村医生入户调查、登记常住人口,以当面询问与观察的方式发现线索患者,并集中推荐到指定医院初筛,疑似患者由结防机构定诊。结果成都市于2009年先后在9个区县入户登记应调查人数3 910 504人,实际调查3 817 928人,调查率97.6%,新发现活动性肺结核411例,其中新发涂阳172例,占41.8%;新发现活动性病例数与涂阳新病例数分别占同期CDC登记总病例数的23.8%和21.9%。结论适时开展入户调查集中推荐可疑者就诊是提高病人发现率的有效方法。通过入户调查、集中推荐工作的实施,有利于现代结核病控制策略落实到基层;有利于提高群众推荐可疑者、可疑者主动就诊的积极性,提高肺结核患者的发现。

Objective This study aims to understand the role and effect of household survey and concentrated recommendation on pulmonary tuberculosis（PTB） case detection.Methods TB suspects were detected through face to face inquiry and observation,and they were referred to designated hospitals through concentrated recommendation for screening.TB patients were confirmed by TB institutions.Results In 2009,nine districts（counties） fully carried out this household survey.A total of 3 910 504 people were registered and 3 817 928 people were investigated,the investigation rate was 97.6%.411 cases of active PTB were detected,among which 172 were new smear positive,accounting for 41.8%.This survey contributed 23.8% and 21.9% respectively in terms of new active case and smear positive case detection in local CDC during the same periods.78.6% of PTB patients detected showed symptoms of cough,expectoration ≥2 weeks or hemoptysis,bloody sputum.Conclusions Household survey and concentrated recommendation of TB suspects is an effective way in improving case detection.Household survey is conducive to the implementation of DOTS strategy and the increase of TB knowledge among general public,benefits understanding of TB prevention among township and village doctors.In addition,this survey could promote the active diagnosis and regular treatment,which ultimately improve PTB case detection.