乌鲁木齐市2012-2015年MTB与HIV双重感染防治效果评价

Effect evaluation of prevention and treatment of MTB and HIV double infection in Urumqi between 2012 and 2015

目的通过对2012-2015年乌鲁木齐市实施过与未实施过＂全球基金MTB与HIV双重感染防治项目＂的各4个县（区）的相关资料进行分析,评价两类县（区）MTB与HIV双重感染防治工作效果,为促进全区双重感染防治工作提供科学依据. 方法收集、整理2012-2015年乌鲁木齐市所辖8个县（区）MTB与HIV 双重感染的患者资料,同时对不同年份、结核病分类、患者性别等数据进行比较分析,评价乌鲁木齐市实施过全球基金项目的4个县（区）（天山区、沙依巴克区、水磨沟区和头屯河区）[简称＂项目县（区）＂],以及未实施过全球基金项目的4个县（区）（高新区、米东区、达坂城区和乌鲁木齐县）[简称＂非项目县（区）＂]的MTB与HIV双重感染的防治效果.结果 2012-2015年,乌鲁木齐市所辖8个县区中新登记结核病患者的HIV抗体检测接受率逐年提高,项目县（区）分别为89.8%（671/747）、92.8%（829/893）、94.2%（843/895）、95.8%（907/947）,差异有统计学意义（x2趋势=24.34,P〈0.01）;非项目县（区）分别为8.2%（44/537）、9.5%（60/630）、61.4%（419/682）、70.7%（467/661）,差异有统计学意义（x2趋势=863.29,P〈0.01）.HIV感染与AIDS患者的结核病筛查接受率逐年提高,项目县（区）分别为54.9%（2146/3906）、57.9%（2133/3681）、66.7%（2763/4140）、82.9%（4243/5116）,差异有统计学意义（x2趋势=981.13,P〈0.01）;非项目县（区）分别为53.4%（134/251）、73.5%（239/325）、84.4%（977/1158）、83.8%（1016/1212）,差异有统计学意义（x2趋势=146.05,P〈0.01）.项目县（区）和非项目县（区）2012-2015年登记转归的MTB与HIV 双重感染患者的抗结核药物治疗成功率分别为82.0%（191/233）和65.4%（17/26）,差异有统计学意义（x2=4.07,P〈0.05）.结论 乌鲁木齐市MTB与 HIV双重感染疫情较为严重,实施过全球基金MTB与HIV双重感染防治项目的县（区）在患者发现和治疗管理工作开展方面远期效果良好,其经验值得推广.

Objective Through the analysis of the relevant data of the four counties （districts） that have implemented and four counties （districts） that have not implemented the Global Fund of MTB and HIV Double Infection Prevention Project in Urumqi between 2012 and 2015, to evaluate the effect of MTB and HIV double infection prevention and control in the two types of counties （districts）, and to provide a scientific basis for promotion of the region＇s double infection prevention and control work. Methods We collected and sorted out the data of patients with MTB and HIV double infection in 8 counties （districts） under the jurisdiction of Urumqi between 2012 and 2015.At the same time, we compared and analyzed the data of different years, tuberculosis classification and patients gender, in order to evaluate the effect of MTB and HIV double infection prevention and control in the 4 counties （districts） （Tianshan district, Shayibake district, Shuimogou district and Toutun River district） （referred to as ＂project counties （districts）＂）, that have implemented Global Fund Project, and the 4 counties （districts） （High-tech zones, Midong district, Dabancheng district and Urumqi county） （referred to as ＂non-project counties （districts）＂） that have not implemented Global Fund Project in Urumqi. Results Between 2012 and 2015, HIV antibody detection rates in the newly registered tuberculosis patients increased year by year in the 8 counties （districts） under the jurisdiction of Urumqi.The rates were 89.8% （671/747）, 92.8% （829/893）, 94.2% （843/895） and 95.8% （907/947） respectively in the 4 project counties （districts）, and the differences were statistically significant （x2trend=24.34, P〈0.01）.The rates were 8.2% （44/537）, 9.5% （60/630）, 61.4% （419/682） and 70.7%（467/661） respectively in non-project counties （districts）, and the differences were statistically significant （x2trend=863.29, P〈0.01）.Tuberculosis screening acceptance rates for HIV-infected and AIDS patients increased year by year.The rates were 54.9% （2146/3906）, 57.9% （2133/3681）, 66.7% （2763/4140）, 82.9% （4243/5116） respectively in the 4 project counties （districts）, and the differences were statistically significant （x2trend=981.13, P〈0.01）.The rates were 53.4% （134/251）, 73.5% （239/325）, 84.4% （977/1158）, 83.8% （1016/1212） respectively in non-project counties （districts）, and the differences were statistically significant （x2trend=146.05, P〈0.01）.Anti-tuberculosis treatment sucess rate among MTB and HIV infected patients registered in 2012-2015 in project counties （districts） and non-project counties （districts） were 82.0% （191/233） and 65.4% （17/26）, respectively.And the differences were statistically significant （x2=4.07, P〈0.05）. ConclusionThe epidemic of MTB and HIV double infection in Urumqi is relatively serious.The counties （districts） implemented with Global Fund of MTB and HIV Double Infection Prevention Project have good long-term effect in patient discovery and treatment management, and their experiences deserve promotion.