2016-2018年南昌市耐多药肺结核医防合作管理模式实施效果评价

Evaluation of the implementation effect of the cooperation between designate hospitals and tuberculosis dispensaries on multi-drug resistant tuberculosis(MDR-TB) control in Nanchang city from 2016 to 2018

目的评价结核病医防合作策略下江西省南昌市耐多药结核病防治工作效果,为建立和完善耐多药结核病医防合作模式提供借鉴。方法对2014年1月-2018年12月期间南昌市疾控中心和结核病定点医院登记的南昌市户籍耐多药肺结核患者129例,数据分析采用SPSS19.0软件进行统计分析;并对该医防合作模式实施前后南昌市耐多药肺结核患者的发现、治疗、管理及转归情况进行对比分析。结果医防合作实施后,南昌市耐多药肺结核患者发现、管理、治疗等各项指标均有不同程度的提升,耐多药高危人群筛查率从23.81%上升到93.66%,新患者病原学阳性肺结核患者耐药筛查率从9.27%上升到63.58%,耐多药肺结核患者检出率从11.51%上升到12.12%,MDR-TB患者纳入治疗率由11.43%提高到64.89%。结论医防合作策略在耐药结核病中发现、治疗、管理及转归等方面取得了良好效果。

Objective To evaluate the implementation effect of the cooperation between designate hospitals and tuberculosis dispensaries on MDR-TB control in Nanchang, and to provide reference for establishing and improving the cooperation model. Methods The 129 cases for Nanchang CDC and tuberculosis hospitals registered Nanchang household MDR-TB patients between January 2014 to December 2018, data were analyzed using SPSS 19.0 software for statistical analysis;According to the medical anti-cooperation strategy, the establishment of the drug-resistant and cooperative management model of multidrug-resistant tuberculosis in line with the characteristics of Nanchang, and the comparative analysis of the findings, treatment, management and outcome of patients with multidrug-resistant pulmonary tuberculosis in Nanchang before and after the implementation of the medical cooperation model. Results After the implementation of medical cooperation, the indicators of discovery, management and treatment of MDR-TB patients in Nanchang have been improved to varying degrees. The screening rate of multi-drug resistant patients was increased from 23.81% to 93.66%. The new patients were pathogenic positive tuberculosis. The drug resistance screening rate increased from 9.27% to 63.58%. The detection rate of MDR-TB patients increased from 11.51% to 12.12%. The treatment rate of MDR-TB patients increased from 11.43% to 64.89%. Conclusion The cooperation strategy had a remarkable effect on multidrug resistant tuberculosis control. The cooperation needs to be further strengthened to further improve the detection and treatment rates of MDR-TB.