2011—2015年深圳市宝安区结核病控制项目效果评价

Effect evaluation on tuberculosis control project in Bao'an District of Shenzhen City from 2011-2015

目的分析2011—2015年深圳市宝安区结核病控制项目的效果。方法对2011—2015年结核病控制项目报表和结核病信息管理系统的资料进行统计分析。结果 2011—2015年宝安区活动性肺结核、涂阳肺结核和新发涂阳肺结核登记率呈逐年下降趋势(χ~2_(趋势)=85.04,73.11,28.08,均P<0.01);转诊到位率、追踪到位率和总体到位率均明显提高(χ~2_(趋势)=301.0,8874.7,368.5,均P<0.01);初治涂阳患者2月末痰检阴转率呈上升趋势(χ~2_(趋势)=14.6,P<0.01);活动性肺结核成功治疗率呈上升趋势(χ~2_(趋势)=12.23,P<0.05);2011—2015年通过结核病控制所减少的死亡人数达1 720例,避免了27 831名健康人受到结核分枝杆菌感染和2 783例新发肺结核患者的产生,通过避免新的患者所减少的直接医疗费用为194.4万元,社会间接经济效益达30亿元。每挽回1个伤残调整生命年(DALY)损失需要投入605元,每投入1元结核病防治经费,可产生128元的社会经济效益。结论深圳市宝安区2011—2015年间结核病防治效果显著,结核病电子网络督导管理模式值得进一步推广,加强疑似肺结核的转诊工作仍将是今后本区结核病防治的重点。

[Objective] To analyze the effect of tuberculosis（TB） control project in Bao＇an District of Shenzhen City from2011-2015. [Methods] The TB control project reports and data from TB information management system from 2011-2015 were statistically analyzed. [Results] The registration rates of active TB, smear-positive TB and initial smear-positive TB cases in Bao＇an District had a rising trend from 2011-2015（χ~2_（trend）=85.04, 73.11, 28.08, all P〈0.01）. Referral arrival rates, tracing arrival rates and overall arrival rates of increased year by year（χ~2_（trend）=301.0, 8 874.7, 368.5, all P〈0.01）. The rates of sputum converting negative in initial smear-positive patients（χ~2_（trend）=14.6, P〈0.01） and successful treatment in active pulmonary TB patients（χ~2_（trend）=12.23, P〈0.05） were rising year by year. The number of deaths reduced by TB control from 2011-2015 was1 720, avoiding 27 831 healthy people suffering from TB infection and 2 783 new TB cases. 194.4 million Yuan of the direct medical expenses and 3 billion Yuan of the social indirect economic benefits reduced by avoiding new patients. A disability adjusted life year（DALY） loss was saved by investing 605 Yuan and 128 Yuan of social and economic benefits can be produced through 1 Yuan tuberculosis prevention and treatment funds. [Conclusion] The effect of preventing and controlling TB is noticeable in Bao＇an District of Shenzhen City. TB electronic direct observation treatment system is feasible and is worth further promotion. It is necessary to strengthen referral of suspected TB in this area.