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目的分析2008-2011年青海省25个贫困县活动性肺结核防治效果,找出工作中存在的问题,提出改进意见,为今后该病的防治工作提供借鉴。方法收集2008-2011年青海省《全国结核病管理信息系统》中由疾控系统工作人员录入并审核的25个贫困县结核病流行病学数据,并进行分析。结果现代结核病控制策略(DOTS)自2005年起就覆盖全省25个贫困县;共发现活动性肺结核患者9 693例,其中痰涂片阳性肺结核患者6 790例,涂阴肺结核患者2 903例;痰涂片镜检阳性肺结核患者治愈率达到92.74%(5 814/6 269),痰涂片镜检阴性肺结核患者治疗完成疗程率为94.51%(2 513/2 659);4年来,共减少因结核病死亡2 394例,并且避免43 428名健康人感染结核菌及4 343例新发结核病患者;减少结核病诊疗相关的医疗费用达到8 946 580元;挽回52 109名伤残调整生命年(DALY);挽回社会经济价值8.14亿元。结论贫困地区结核病防治效果显著,社会效果/效益良好,减少了对经济建设和社会发展的阻碍;为贫困地区今后开展结核病防治工作提供了有效模式。
Objective To analyze the prevention and control of active tuberculosis in 25 poverty-stricken counties in Qinghai Province during 2008-2011, find the problems existing in the work, put forward the suggestions for improvement and provide references for the future prevention and treatment of this disease. Methods The epidemiological data of tuberculosis in 25 poverty-stricken counties from 2008 to 2011 in National TB Management Information System of Qinghai Province collected and reviewed by CDC staff were collected and analyzed. Results The current strategy of controlling tuberculosis (DOTS) has covered 25 poverty-stricken counties in the province since 2005. A total of 9 693 active tuberculosis patients were found, of which 6 790 were sputum smear-positive pulmonary tuberculosis patients and 2 903 were smear-negative pulmonary tuberculosis patients. The cure rate of sputum smear-positive pulmonary tuberculosis patients was 92.74% (5 814/6 269), and the sputum smear-negative patients with tuberculosis was 94.51% (2 513/2 659). In 4 years, 2 394 deaths from tuberculosis and 43 428 healthy people were prevented from contracting TB and 4 343 new TB cases; reducing the medical expenses related to TB diagnosis and treatment to RMB 8 946 580; and saving 52 109 disability-adjusted life years (DALY) ; Restore social and economic value of 814 million yuan. Conclusion The prevention and treatment of tuberculosis in poverty-stricken areas are significant, with good social effects / benefits, reducing the obstacles to economic construction and social development, and providing an effective model for TB prevention and control work in poor areas in the future.