经济社会因素对“涂阳肺结核病人密切接触者检查”工作的影响

Study on unfavorable socioeconomic factors in screening of the close con tacts of smear positive pulmonary tuberculosis patients

目的了解影响"涂阳肺结核病人密切接触者检查"工作的社会经济因素。方法使用自行设计的问卷和访谈提纲对涂阳肺结核病人及其密切接触者分别进行定量调查和半结构式访谈。结果访谈发现,多数人会疏远肺结核患者,多数肺结核病人不愿意将病情告知其身边的同事或朋友。36.5%的受访者不认为肺结核具有传染性或不清楚其是否具有传染性;32.8%的受访涂阳患者认为肺结核造成经济负担,68.7%的对费用报销不满意;43.3%以上的受访患者在县级及以上的综合医院接受抗结核治疗;45.8%的受访密切接触者未接受接触者筛查。结论社会歧视、对结核病的传染性缺乏认识、医疗费用及结核病防治分离等可能是影响涂阳肺结核病人接触者检查工作的因素。

Objective To ascertain the socioeconomic factors that have negative effects on the work of screen for the close contacts of smear positive pulmonary tuberculosis.Methods Both quantitative and qualitative surveys were employed to investigate patients with smear positive pulmonary tuberculosis and their close contacts.Results The most people would stay away from patients with pulmonary tuberculosis and the majority of patients with pulmonary tuberculosis were reluctant to inform their colleagues or friends about their illness in the interview;36.5% of responders had no correct understanding on the infectious of pulmonary tuberculosis;32.8% of responders with pulmonary tuberculosis thought that tuberculosis places a big financial burden,and 68.7% of them were not satisfied with the reimbursement from medical insurance;43.3% of responders with smear-positive pulmonary tuberculosis patients were under treatment at the county and the above comprehensive hospital;45.8% of close contact of smear positive pulmonary tuberculosis did not accept screen.Conclusion Social discrimination,lack of awareness on TB infection,medical expenses,and treatment and preventive separation are possible negative factors of screen for the close contacts of smear positive pulmonary tuberculosis.