湖北省实施DOTS策略十年效果分析

The results of implementation of DOTS for treatment of pulmonary tuberculosis in Hubei Province in 1992～2002

目的 评价湖北省实施DOTS(DirectlyObservedTherapy ,Short -Course)策略 10年效果。 方法 对 1992～2 0 0 2年湖北省世行贷款结核病控制项目季报表 ,2 0 0 2年湖北省世行贷款结核病控制项目终期评价调查表等进行分析和评价。 结果 10年间 ,全省累计接诊肺结核可疑症状者 64 2 976人 ,发现涂阳肺结核病人 172 885例 ,涂阳新登记率达到了 2 5 6 10万 ,治愈率达到 94 7% ,新发涂阳病人治愈后 3年和 5年细菌学复发率分别为 2 5 %、4 9%。 结论 DOTS策略的实施 ,提高了肺结核病人发现和治疗管理水平 。

Objective To evaluate the effect of DOTS implemented in Hubei Province Methods The seasonal reporting forms of TB controf program carried in Hubei Province using World Bank loan in 1992～2002.and the results of for final assessment of the program were collected and analyzed. Results 172 885 smear-positive pulmonary TB cases were identified 642 976 suspects consulted at TB dispensaries The average registration rate of Smear-positwe cases reached 25 6/10 5 compared with that of 9 7/10 5 before DOTS (1982～1991) The cure rate reached 94 7% compared with that of 62 7% before DOTS The cohort analysis of 172 885 smear-positive cases was as follows,163 666(94 7%)were cured 3 542(2 0%) treated in full course,1 402(0 8%) failed 1 769(1 0%)died, 1 646(1 0%)defaulted,424(0 2%)referred,other 436(0 3%),Three-year and five-year bacteriological recrudescence rates after cure were 2 5% and 5 1% respectively Conclusion The detection rate and managerial level was enhanced,and the recrudescence rate and the occurrence of drug resistance were reduced after the implementation of DOTS