2016-2020年江苏省耐药结核病防治实施效果分析

Evaluation of drug resistant tuberculosis prevention and control in Jiangsu,2016−2020

目的评价2016—2020年江苏省耐药结核病防治实施效果,为制定下一步耐药结核病防治政策提供依据。方法采用统一的“十三五”江苏省结核病防治规划中期评估现场调查表,调查内容包括耐药结核病防治经费投入情况、结核病防治机构人力资源和实验室能力情况、二线抗结核药品供应情况等,并收集2016—2020年结核病信息管理系统数据。结果“十三五”期间,江苏省耐药结核病防治经费呈逐年上升趋势,从2016年的315.50万元上升到2020年的4496.00万元,疾病预防控制机构结核病防治人员数量总体平稳,结核病定点医疗机构人员数量有所提高,二线抗结核药品纳入政府集中采购。2016—2020年期间,江苏省登记肺结核患者病原学阳性率逐年上升,从33.50%上升至58.33%(趋势_(χ^(2))=5230.907,P<0.001);病原学阳性患者耐药筛查率从49.70%上升至97.70%(趋势_(χ^(2))=12213.323,P<0.001);耐药筛查平均诊断时间从64.75 d下降至5.95 d(T=12519.070,P<0.001);利福平耐药患者纳入治疗率从61.52%上升至97.75%(趋势_(χ^(2))=279.352,P<0.001);利福平耐药患者成功治疗率从63.86%上升至80.84%(趋势_(χ^(2))=29.547,P<0.001),均显著提高。结论江苏省耐药结核病防治取得显著成效,实现“十三五”防治规划目标,其主要原因是加大经费投入、引进先进技术、扩大耐药筛查范围、保障药品供应等措施的落实。

Objective To evaluate the performance of drug-resistant tuberculosis(DR-TB)prevention and control in Jiangsu province from 2016 to 2020,and provide evidence for the further improvement of DR-TB prevention and control policy.Methods A unified field questionnaire was used for the mid-stage evaluation of the investment for the prevention and control of DR-TB,the human resources and laboratory capacity of TB prevention and control institutions and the supply of second-line anti-TB drugs in the TB control program in Jiangsu during the 13th Five-Year Plan period.The data from the TB Information Management System during this period were collected.Results The investment for the prevention and control of DR-TB in Jiangsu increased year by year,from 3.16 million yuan(RMB)in 2016 to 44.96 million yuan(RMB)in 2020.The anti-TB forces in centers for disease control and prevention remained stable,the professionals in designated medical institutions increased and the second-line anti-TB drugs have been included in government centralized procurement list.From 2016 to 2020,the proportion of laboratory confirmed pulmonary TB cases increased from 33.50%to 58.33%(trend_(χ^(2))=12213.323,P<0.001),the drug resistance screening rate in laboratory confirmed TB cases increased from 49.70%to 97.70%(trend_(χ^(2))=12213.323,P<0.001),the average time for DR-TB diagnosis dropped from 64.75 days to 5.95 days,the treatment rate of rifampicinresistant TB cases increased from 61.52%to 97.75%,the successful treatment rate of RR-TB increased from 63.86%to 80.84%(trend_(χ^(2))=29.547,P<0.001)Conclusion Achievement has been made in the prevention and control of DR-TB in Jiangsu,reaching the target set the TB control program in the“13th Five-Year Plan”period.which might be attributed to the increased investment,expanded drug resistance screening,application of advanced technology and consistent drug supply.