第五轮中国全球基金结核病项目随州市Mtb与HIV双重感染防治效果评价

Study on the effect evaluation of the Fifth Round of Global Fund Program on Mtb and HIV co-infection control

目的对第五轮中国全球基金结核病项目随州市Mtb与HIV双重感染防治项目效果进行评价研究。方法收集随州市CDC结核病防治所(简称"结防所")2006年第4季度至2010年第4季度的季报表、年报表、专题调查等资料,建立数据库,进行统计分析。结果项目期间,共登记活动性TB患者4077例(其中HIV感染者与AIDS患者开展TB筛查发现活动性TB患者21例),TB患者开展HIV抗体检测4056例,检测率达100.00%(4056/4056);HIV阳性检出率为0.15%(6/4056)。可随访的HIV感染者及AIDS患者1521例,接受TB筛查率达92.64%(1409/1521);TB患者发现率为1.49%(21/1409),是TB患者检出HIV阳性率(0.15%)的9.93倍。共登记Mtb与HIV双重感染者27例,抗结核治疗27例,治愈或完成疗程81.48%(22/27),失败3.70%(1/27),死亡11.11%(3/27)。HIV感染者及AIDS患者中TB检出率5年中由5.17%(12/232)下降到0.67%(2/300),差异有统计学意义(χ2=13.267,P=0.000)。结论Mtb与HIV双重感染防治工作重点在于及时发现和治疗HIV感染者及AIDS人群中的TB患者。TB和AIDS双向筛查,以及对Mtb与HIV感染或患者进行抗结核治疗对于控制TB和AIDS的流行有重要意义,应长期开展。

Objective To evaluate the effect of the Fifth Round of Global Fund Program on Mtb/HIV co-infection control in Suizhou city.Methods Quarterly and annual reports,special survey data were collected between the fourth quarter of 2006 and the fourth quarter of 2010 from Suizhou CDC.Database was established for statistical analysis.Results During the program implementation period,4077 TB patients were registered（among which,21 cases were detected from TB screening among HIV/AIDS patients）,the remaining 4056 cases received HIV antibody test,the examination rate reached 100.00%（4056/4056）,and HIV positive detection rate was 0.15%（6/4056）.Regarding TB screening among HIV/AIDS patients,among 1521 cases of HIV/AIDS patients being followed-up,92.64%（1409/1521） received TB screening.The corresponding TB detection rate was 1.49%（21/1409）,which was 9.93 times of HIV detection rate among TB patients.A total of 27 Mtb/HIV patients were registered,all of them were administered anti-TB medication,the cure and treatment completion rate were 81.48%（22/27）,treatment failure rate was 3.70%（1/27） and the death rate was 11.11%（3/27）.The detection rate of active tuberculosis among HIV/AIDS patients decreased significantly from 5.17%（12/232） to 0.67%（2/300） in past 5 years（χ^2=13.267,P=0.000）.Conclusion The work of Mtb/HIV co-infection control should be focused on detection of TB cases among people living with HIV/AIDS.TB detection among HIV/AIDS patients,HIV tests among TB patients and anti-TB medication for Mtb/HIV patients are important in control of Mtb/HIV epidemic,and should carry out on a long-term basis.