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目的探讨建立农村地区结核病防治体系控制肺结核流行的技术策略,为政府决策提供科学依据。方法通过世行贷款/英国赠款、全球基金及FIDELIS三个结核病控制项目的实施,筛选科学有效的肺结核防治策略,回顾性分析预防控制效果以检验其可行性。结果全市肺结核免费筛查范围扩大3.3倍,医疗机构疑似病人报告率提高31.3%,全人口初诊病人就诊率提高202%,新涂阳肺结核病人发现率由33.3%提高到72.2%,新涂阳病人2月末痰菌阴转率由88.7%提高到93.8%,治愈率由84.1%提高到92.7%;肺结核病人就诊延迟率由71.7%下降至40.0%,治疗中断率由9.1%下降至4.2%,农村群众结核病防治知识知晓率由31.2%提高到65.6%,每年可保护健康人群5.38万人,7年累计减少肺结核病人37660人。结论坚持一个原则,建立一个机制,加强一个建设,落实一个保障,健全一个网络,实施一个规范,推行四大策略的农村地区结核病防治体系和工作模式,预防控制效果良好,社会效益显著,对实现结核病防治规划目标,提高整体工作质量有明显推动作用。
Objective To explore the technical strategy of establishing a tuberculosis control system in rural areas to control the prevalence of tuberculosis and provide a scientific basis for government decision-making. Methods Through the implementation of three TB control projects, including World Bank Loan, British Grants, Global Fund and FIDELIS, we screened for a scientific and effective TB control strategy and retrospectively analyzed the effectiveness of prevention and control to test its feasibility. Results The scope of free screening for tuberculosis in the whole city expanded 3.3 times, the report rate of suspicious patients in medical institutions increased by 31.3%, the visiting rate of newly diagnosed patients in population increased by 202%, the detection rate of new smear positive pulmonary tuberculosis increased from 33.3% to 72.2% At the end of February, the sputum negative conversion rate increased from 88.7% to 93.8%, the cure rate increased from 84.1% to 92.7%; the delay rate of tuberculosis patients dropped from 71.7% to 40.0%, and the treatment interruption rate dropped from 9.1% to 4.2% The awareness rate of people’s knowledge of tuberculosis prevention and control increased from 31.2% to 65.6%, protecting 53,800 healthy people each year and reducing the number of tuberculosis patients by 37,660 in seven years. Conclusion Adherence to one principle, establishing a mechanism, strengthening one construction, implementing a guarantee, perfecting a network, implementing a four-pronged TB prevention and control system and working mode in rural areas, with good prevention and control effects, significant social benefits, Tuberculosis prevention and control planning objectives, improve the overall quality of work has obvious role in promoting.