2000年全国结核病流行病学抽样调查报告

Report on nationwide random survey for the epidemiology of tuberculosis in 2000

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 1 0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 57个。对 0～ 1 4岁儿童进行结核菌素试验 ,≥1 5岁人群和结核菌素反应≥ 1 0mm的儿童进行胸透 ,对胸透异常和咳嗽咳痰症状 3周或以上者进行摄片、痰涂片和培养检查 ,培养阳性进行抗结核药物敏感试验 ,对活动性肺结核病人进行社会经济调查。对 59个点进行全人口感染率调查。对 1 999年死亡情况进行回顾调查。结果 实检人口为 3650 97人 ,占应检人口的 97.2 %。活动性肺结核患病率为 367/ 1 0万、菌阳肺结核患病率为 1 60 / 1 0万、涂阳肺结核患病率为 1 2 2 / 1 0万 ,经标准化的患病率与 1 979年相比活动性肺结核年递降率为 4 .5% ,涂阳患病率为 3 .8% ,与 1 990年比年递降率分别为 5 .4%和 3 .2 % ;1 990～2 0 0 0年间涂阳患病率卫V项目地区下降幅度为 44 .4% ,而非项目地区下降 1 2 .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 ,下降缓慢。

Objectives To realize the dynamic status of the epidemiological situation of tuberculosis in the Country and evaluate the efficacy of control measures as well as to provide the scientific basis for the preparation of The National Tuberculosis Control Program (2001～2010). Method The multi-stratified grouping random sampling method was used and the proportional sampling was utilized for the country as a whole. A total of 257 investigation points was sampled. Tuberculin testing was carried out among all children of 0～14 age group. Chest X-ray fluoroscopy was applied to all population ≥ 15 years of age and the testees of children with positive tuberculin reaction (≥10mm). Chest X-ray radiography, sputum direct smear and cultural examination were applied to all tuberculosis symptomatic with cough and expectoration more than three weeks and all examinees with abnormal finding during fluoroscopy. Sensitivity testing of anti-tuberculosis drugs was conducted for all isolated colonies from positive sputum cultural examination. Socio-economic study was carried out among all detected tuberculosis patients. The investigation of tuberculosis infection among whole population was conducted in 59 investigation points. A retrospective study of tuberculosis mortality was investigated.Results The actual examined population in this survey was 365?097 and occupied 97.2% of the eligible population. The standardized prevalence of active, smear positive and bacteriological positive pulmonary tuberculosis were 367/ 100?000, 160/100?000 and 122/100?000 respectively. The annual reduction rates between 1979 and 2000 for active and smear positive pulmonary tuberculosis were 4.5% and 3.8% respectively. The corresponding annual reduction rates between 1990 and 2000 were 5.4% and 3.2% respectively. The smear positive prevalence in project areas showed a 44.4% declining between 1990 and 2000 and it was only 12.3% in non-project areas. The epidemiological situation of tuberculosis in western areas of the Country was much serious than the national average. Conclusion The magnitude of tuberculosis in the Country was still serious and it was inequable in different areas. The improvement of the national epidemiological situation was rather sluggish.