1992～2001年湖南省世界银行贷款结核病控制项目实施效果分析与评价

Analysis and Evaluation of Effects of Hunan Provincial Tuberculosis Control Project Loaned by the World Bank during the Past Ten Years(1992～2001)

目的 分析和评价湖南省 1 992～ 2 0 0 1年实施世行贷款结核病控制项目工作成效。 方法 对湖南省 1 992～2 0 0 1年世行贷款结核病控制项目报表资料和终期评估调查资料统计分析。 结果 1 .全省以县为单位 DOTS策略覆盖率达 1 0 0 % ,全省 DOTS策略人口覆盖率达 95%以上 ,引进了 DOTS新技术 ;2 .采取世行贷款和各级政府经费配套的筹资模式 ,加强了政府对结核病控制的经费投入 ,项目经费投入超过项目实施前 40年经费投入的总和 ;3.免费发现活动性肺结核病人 2 4 3 553例 ,免费治疗传染性肺结核病人和重症涂阴肺结核病人 2 0 0 4 4 8例。涂阳病人登记率自 1 992年的 4.9/1 0万提高到 2 0 0 1年的 30 .1 / 1 0万 ,平均治愈率为 91 .2 % ,达到项目目标。 结论 1 .项目推行的 DOTS策略 ,加强了政府对结核病控制的领导 ,提高了政府对结核病控制的经费投入 ,建立起了结核病控制由政府领导、多部门合作、全社会参与的结核病控制机制 ;2 .执行 DOTS策略的各项技术措施 ,提高了传染性肺结核病人的发现率和治愈率 ,有效地控制了传染源 ;3.是最符合成本

Objective To analyze and evaluate the effect of TB control project in Hunan province supported by the World Bank loan during the past ten years. Methods To analyze the data from quarter reports and final evaluation investigation report of TB control project in Hunan province. Result 1.The coverage rate of TB control strategy (DOTS) arrived at 100% according to county as base unit and 95% of all provincial population. DOTS new technology was Introduced. 2.The governmental financial input to TB control was strengthened by applying the World Bank Loan and counterpart funds of all level government, and the amount of input surpassed the total input of 40 years before the project implementation. 3.243,553 of active pulmonary TB cases was detected out and 200,448 cases of smear positive and severe smear negative patients treated free of charge. Registration rate of smear positive PTB cases increased from 4.9/100,000 population in 1992 to 30.1/100,000 population in 2001,and average cure rate arrived at 91.2%. Conclusion 1.The DOTS strategy recommended by the project has strengthened the leading role of government on TB control, and increased the financial input. A mechanism led by the government, cooperated by multi-sector, and participated by the society was established. 2.Due to the smooth implementation of every technique measure, the case detection and cure rate of infectious patients increased and the proportion of re-treatment patients decreased. The infectious sources were controlled effectively, and the prevalence of TB reduced. 3. This project is the most cost-effective TB control project.