湖南省复治涂阳肺结核病人社会因素调查与分析

The Social Factors of Retreated Smear Positive Pulmonary Tuberculosis Cases in Hunan Province

目的 调查和分析湖南省实施DOTS策略下复治涂阳肺结核病人的来源和社会因素现状 ,为研究和制订干预措施提供依据。 方法 抽样调查全省 30个结核病控制项目实施县 2 0 0 1年 7～ 1 2月登记的复治涂阳肺结核病人 ,并对病人进行问卷调查。 结果 调查 42 0例复治涂阳肺结核病人中 ,来源于其他复治 2 86例 (68.1 % ) ,是复治涂阳肺结核病人的主要来源。各种社会因素调查中 ,少数民族病人 39例 (1 1 .2 % ) ;小学文化程度和文盲达 2 66例 (63 .3 % ) ;家庭经济与本村村民相比 ,2 2 5个 (53 .6 % )的家庭贫困 ;93 .3 %的病人距村卫生室小于 3km ;41 .9%的病人距县防疫站大于2 5km ;病人患病前仅 1 60人 (38.1 % )接受不同形式的结核病防治知识的宣传。 结论 本资料表明应切实加强结核病人的转诊和归口管理 ,减少复治涂阳肺结核病人的产生。同时 ,在制定结核病控制对策和实施方法中 。

Objective To investigate and analyze the source and social factors of retreated smear positive pulmonary Tuberculosis (TB) cases in DOTS areas and to provide the evidence for interventions. Methods To conduct sampling survey on registered retreated smear positive pulmonary TB cases of 30 counties implementing TB control project during July and December 2001. Result There are 286(68.1%) retreated cases out of 420 cases as the main source of retreated smear positive pulmonary TB cases. Among all cases we investigated: 39 cases are minority people (11.2%), 266 cases are illiterate or with primary education (63.3%); compare with the average revenue of the village, 225 cases are poverty family (53.6%); 93.3% cases live in the place that is less than 3 km away from the village dispensary, 41.9% cases more than 25 km away from the local dispensary; about 160 cases (38.1%) received some health education on TB control and prevention before they are diagnosed. Conclusion It suggests that to strengthen the referral management of TB patients is an effective way to reduce retreated cases. In addition to TB control strategy and method, more attention should be paid to social factors.