四川省“十二·五”结核病防治规划实施效果分析

Implementation Effect of National Tuberculosis Control Program of Twelfth Five-year Plan in Sichuan Province,2011-2015

目的通过《四川省结核病防治规划(2011-2015年)》(《规划》)中期主要指标的评估分析,掌握《规划》实施进展和质量,提出下一步改进措施。方法由省级制定统一的评估方案和调查表格,在培训的基础上开展自评、现场抽查和核查,数据录入EpiData软件进行汇总分析。结果各级《规划》制定率100%,防治经费21 168万元,平均每个县(区)6.7个专业人员;47.6%市级和59.6%县级将结核病患者门诊费用纳入医保,52.3%市将耐多药肺结核患者纳入门诊医保;实验室体系建设基本完成,14个市级实验室达到二级生物安全标准;发现及治疗管理肺结核患者178 836例,新涂阳患者治愈率为94.55%,总体到位率95.81%;33%市级开展耐多药结核病防治,100%重点县开展了TB/HIV双重感染防治;结核病防治核心信息知晓率从2010年的53.09%提高到了2013年的79%。结论全省《规划》进展顺利,主要工作指标达到中期要求,实验室能力及新型服务体系建设成效突出。但在经费及政策保障、人力资源、DOTS实施质量、地区间发展平衡等方面有待进一步强化。

Objective To evaluate progress and quality of tuberculosis(TB)control program in Sichuan TB Control Program(2010-2015)(Program)from 2011 to 2015by analyzing the major indexes,and to put forward further improvement.Methods Uniform scheme and questionnaires designed by provincial experts were adopted for self-assessment and field check and inspection.The data were entered into Epidata for analysis.Results Governments at all levels developed TB prevention and control program,allocating a total of211.68 million Yuan.Each county had 6.7professionals on average;47.6%of the cities and 59.6%counties brought the active TB outpatient into medicare reimbursement while 52.3%cities brought the MDR-TB outpatient into medicare reimbursement.Laboratory systems were completed and 14 municipal laboratories reached to the grade 2biosafety standards.A total of 178 836 cases were detected and treated.The cure rate of new smear-positive patients was 94.55%,the overall arrival rate was 95.18%.MDR-TB could be diagnosed and treated in 33% of the cities,and 100% of the counties carried out TB/HIV double infection prevention and control.The awareness rate of the core message increased from53.09% in 2010 to 79% in 2013.Conclusion The implementation of the program is in smooth progress and the midterm goal has been achieved in time.Priority areas,laboratory capacity and the new service system have achieved remarkable success.However,funding and policy supports,human resources,the quality of DOTS and regional balance still need to be enhanced in future.