全球基金结核病项目安徽省试点耐多药结核病综合防治效果分析

Analysis on the effect evaluation of the Global Fund Tuberculosis Project on MDR-TB control in the pilot city of Anhui Province

目的 对2012年1月1日至2014年6月30日期间,全球基金结核病项目安徽省安庆和阜阳2个试点市的耐多药结核病综合防治效果进行分析,为进一步在全省范围实施耐多药结核病的控制工作提供借鉴.方法 以安庆市和阜阳市为试点实施全球基金耐多药结核病防治项目（简称“全球基金项目”）,采用耐药肺结核管理策略（PMDRT）建立了“以地市为中心、县区为枢纽、社区为依托”的耐多药结核病诊断、治疗、管理工作综合防治模式.根据2012年1月1日至2014年6月30日期间安庆市和阜阳市项目季度报表、月报表和耐多药结核病防治工作督导报告及两市的结核病网络专报系统,共计收集可疑耐多药结核病患者1015例,对这些患者的临床统计资料进行回顾性分析.结果 在上述时间段,安庆和阜阳2个试点市对1015例耐多药结核病可疑者进行了筛查,其中痰培养993例;对776例痰培养阳性患者进行了药物敏感性试验（简称“药敏试验”）,确诊为耐多药肺结核患者158例,纳入全球基金项目治疗的患者125例,其他患者因治疗前检查待治、拒治、失访、死亡等原因未纳入全球基金项目治疗.纳入治疗的125例耐多药结核病患者中,治愈和完成疗程66例,治疗成功率52.8％.结论 两试点市建立的耐多药结核病综合防治模式取得了一定成效,但仍需进一步加强耐多药患者的发现和管理,并最终达到满意的治疗转归结果.

Objective The purpose of this study was to analyze the effect of the global fund tuberculosis project on MDR-TB control in Anqing city and Fuyang city of Anhui Provincial from January 1,2012 to June 30,2014,and provide further reference for the implementation of MDR-TB control work in the province.Methods The Global Fund Tuberculosis Project on MDR-TB control was implemented in two pilot cities Anqing and Fuyang.PMDRT strategy was used to establish a comprehensive prevention and control model for the diagnosis,treatment and management of MDR-TB,which was based on the city as the center and the county as the hub and the community as the base.According to the report of Anqing City and Fuyang City from January 1,2012 to June 30,2014,1015 cases of suspected drug-resistant tuberculosis and their clinical statistics were collected.Data were retrospectively analyzed.Results During the above period,a total of 1015 MDR-TB suspects in Anqing city and Fuyang city were screened,and among of them,993 cases were cultured and 776 cases with cultured positive result were per formed drug susceptibility test （DST）.Finally,158 cases were diagnosed as the MDR-TB,and 125 cases were included in the treatment.Other patients due to failed in the pre-treatment check,refused the treatment,lost,death and other reasons were not included in the treatment.At last,66 cases were cured or completed the treatment course,and the treatment success rate was 52.8%.Conclusion The comprehensive prevention and control model of MDR-TB in the two pilot cities have achieved certain results,but it is still necessary to further strengthen the discovery and management of MDR-TB patients and finally achieve satisfactory outcome of treatment.