第四次全国结核病流行病学抽样调查报告

Report on fourth national epidemiological sampling survey of tuberculosis

目的 了解全国的结核病疫情动态 ,评价防治措施的效果 ,为制定 2 0 0 1～ 2 0 10年结核病防治规划提供科学依据。方法 采取分层整群等比例随机抽样 ,全国调查点 2 5 7个。对 0～ 14岁儿童进行结核菌素试验 ,对≥ 15岁人群和结核菌素反应≥ 10mm的儿童进行胸透 ,对胸透异常和咳嗽、咳痰症状≥ 3周者进行摄片、痰涂片和培养检查 ,对培养阳性者进行抗结核药物敏感试验 ,对活动性肺结核患者进行社会经济状况调查。对 5 9个点进行全人口感染率调查。对 1999年死亡情况进行回顾调查。结果 实检人口为 36 5 0 97人 ,占应检人口的 95 %以上。活动性肺结核患病率为 36 7/ 10万、菌阳肺结核患病率为 16 0 / 10万、涂阳肺结核患病率为 12 2 / 10万 ,经标准化的患病率与 1979年相比活动性肺结核年递降率为 4 5 % ,涂阳肺结核年递降率为 3 8% ,与 1990年相比年递降率分别为 5 4%和3 2 % ;1990～ 2 0 0 0年间涂阳患病率卫V项目地区下降 44 4% ,而非项目地区下降 12 3% ,西部地区疫情高于全国平均水平。结论 全国的结核病疫情仍很严重 ,各地不平衡 。

Objective To investigate the epidemiological trend of tuberculosis,to evaluate the efficacy of control measures and to provide scientific basis for making National Tuberculosis Control Programme 2001～2010. Methods Tuberculin testing was carried out among 0～14 years old children;fluroscopy was carried out for ≥15 years old population and children with ≥10 mm reaction of tuberculin testing;chest X-ray film,sputum smear and culture were done for the patients of fluroscopy abnormal and suspects of tuberculosis symptom(persistent cough for 3 weeks or more); drug sensitivity test was done for the patients with culture positive; a retrospective study of tuberculosis mortality in 1999 was conducted at all investigation points; social economic study was done for the active pulmonary tuberculosis cases; the survey of tuberculosis infection rate for all population was carried out in 59 investigation points. Results The population actually examined in this survey numbered 365 097.The examination rate was more than 95%. The prevalence of active pulmonary tuberculosis was 367/100 000,the prevalance of smear positive pulmonary tuberculosis was 122/100 000 and the prevalence of bacteriological positive pulmonary tuberculosis was 160/100 000. In comparison with 1979,the annual reduction rates were 4.5% for the standardized prevalence of active pulmonary tuberculosis and 3.8% for the standardized prevalence of smear positive pulmonary tuberculosis. In comparison with 1990,the annual reduction rates were 5.4% and 3.2%,respectively. The smear positive prevalence standardized showed a 44.4% decrease in the regions of implementing project of Health V but only 12.3% decrease in the regions without the project. The prevalence in the west region was higher than national average prevalence. Conclusions The epidemic of tuberculosis is still serious and prevalence decrease was slow. The governments at different levels must pay more attention to tuberculosis control programme,increase budget,implement DOTS strategy .