黑龙江省全球基金结核病项目实施及结束后耐多药肺结核患者发现情况分析

Changes in MDR pulmonary TB detection during and after Global Found project： a situation analysis in Global Fund TBproject areas in Heilongjiang province

目的分析黑龙江省全球基金结核病项目地区实施期间及项目结束后耐多药肺结核患者发现情况。方法从中国结核病信息管理系统选取3个全球基金项目地区（大庆市、哈尔滨市和齐齐哈尔市）项目实施期间（2013年1月至2014年6月）和项目结束后（2014年7月至2015年12月）的数据，采用卡方检验的统计分析方法，对3个项目地区实施期间和结束后耐多药可疑者筛查率、痰培养检出率、药物敏感性试验（简称“药敏试验”）耐多药患者检出率和广泛耐药患者检出率进行回顾性对比分析，以P〈0．05为差异有统计学意义。结果项目实施期间和项目结束后耐多药可疑者筛查率分别为85．7％（724／845）和88．7％（517／583），两组差异无统计学意义（χ^2=2．726，P=0．099）；痰培养阳性检出率分别为93．6％（678／724）和69．1％（357／517），两组差异有统计学意义（χ^2=131．783，P=0．000）；药敏试验耐多药患者检出率分别为20．2％（132／655）和12．5％（34／272），两组差异有统计学意义（χ^2=7．656，P=0．006）；广泛耐药患者检出率分别为5．6％（37／655）和2．2％（6／272），两组差异有统计学意义（χ^2=5．150，P=0．023）。结论黑龙江省项目结束后痰培养阳性患者、耐多药及广泛耐药肺结核患者数量减少，项目实施效果显著。

Objective To analyze the situation changes in case finding of multidrug-resistant tuberculosis （MDR-TB） during and after the implementation of the Global Fund TB project in Heilongjiang province. Methods The relevant data, which reflected the situation of MDR-TB case detection during the implementation of the Global Found TB Project from January 2013 to June 2014 and after the project from July 2014 to December 2015 in three cities （Daqing, Harbin and Qiqihar） of Heilongjiang province, were collected through the Tuberculosis In- formation Management System of China. The MDR-TB suspects screening rate, sputum culture positive rate, MDR-TB detection rate through drug susceptibility test （DST） and extensively drug-resistant TB （XDR-TB） detec- tion rate through DST were retrospectively analyzed. Z2 test was used for statistical analysis and P〈0.05 was con- sidered to be statistically significant difference. Results During the project implementation period and after the project, the MDR-TB suspects screening rate was 85.7% （724/845） and 88.70% （517/583） respectively, and the difference between the two groups had no statistical significance （Z2 =2. 726, P=0. 099）; the sputum culture posi- tive rate was 93.6% （678/724） and 69.1% （357/517） respectively, and the difference between the two groups had statistical significance （χ^2= 131. 783, P= 0. 000）; the MDR-TB patients detection rate by DST was 20. 2% （132/655） and 12.5% （34/272） respectively, and there was significant difference between two groups （χ^2= 7. 656, P=0. 006） ; the XDR-TB detection rate by DST was 5.6% （37/655） and 2.2% （6/272） respectively, and there was significant difference between two groups （χ^2=5. 150, P=0. 023）. Conclusion After the Global Found pro- ject, the detection of sputum culture positive TB patients, the number of MDR-TB and XDR-TB patients had signi- ficantly reduced in Heilongiiang province compared with the number during the implementation of the project.