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目的分析大连市17年来肺结核病的控制状况,为今后结核病控制的可持续发展提供技术策略。方法收集并分析1992—2008大连市7个区县项目季报表、流行病学调查及有关资料。结果大连市17年间累计接诊可疑肺结核病人339 931例,发现活动性肺结核病人33 189例,其中新发涂阳肺结核病人14 746例,涂阳新登率由项目前的4.4/10万上升到29.08/10万。初、复治涂阳病人治愈率达93.65%和88.24%,比项目前的65%提高了近30个百分点。结论大连市结核病控制项目取得了明显的社会效益和经济效益。涂阳病人发现率及治愈率的逐年提高,符合结核病控制项目高发现率、高治愈率的要求,达到了控制传染源的目的,其主要原因是行政干预、结核病防制宣传和直接面视下短程化疗(DOTS)策略的落实。
Objective To analyze the control status of tuberculosis in Dalian for 17 years and provide technical strategies for the sustainable development of tuberculosis control in the future. Methods The project quarterly reports, epidemiological investigation and related data of 7 districts and counties in Dalian during 1992-2008 were collected and analyzed. Results A total of 339 931 suspicious TB patients were admitted to Dalian during the 17 years. A total of 33 189 active TB cases were found, of which 14 746 were new smear-positive pulmonary tuberculosis patients. The new smear-positive rate rose from 4.4 / 100 000 before the project to 29.08 /100,000. At the beginning of treatment, the cured rate of smear-positive patients reached 93.65% and 88.24%, which was nearly 30% higher than the 65% before the project. Conclusion TB control project in Dalian has achieved obvious social and economic benefits. The detection rate and cure rate of smear positive patients increased year by year, which accorded with the requirement of high detection rate and high cure rate of TB control project, and reached the purpose of controlling the source of infection. The main reasons were administrative intervention, publicity of TB prevention and control and direct visual inspection Implementation of short-course chemotherapy (DOTS) strategy.