高级检索
陈彬, 王晓萌, 钟节鸣, 陈松华. 浙江省5地市耐多药结核病防治策略效果评价[J]. 中国公共卫生, 2014, 30(4): 385-387. DOI: 10.11847/zgggws2014-30-04-01
引用本文: 陈彬, 王晓萌, 钟节鸣, 陈松华. 浙江省5地市耐多药结核病防治策略效果评价[J]. 中国公共卫生, 2014, 30(4): 385-387. DOI: 10.11847/zgggws2014-30-04-01
CHEN Bin, WANG Xiao-meng, ZHONG Jie-ming.et al, . Evaluation on multi-drug resistant tuberculosis control strategies in 5 pilot cities in Zhejiang province[J]. Chinese Journal of Public Health, 2014, 30(4): 385-387. DOI: 10.11847/zgggws2014-30-04-01
Citation: CHEN Bin, WANG Xiao-meng, ZHONG Jie-ming.et al, . Evaluation on multi-drug resistant tuberculosis control strategies in 5 pilot cities in Zhejiang province[J]. Chinese Journal of Public Health, 2014, 30(4): 385-387. DOI: 10.11847/zgggws2014-30-04-01

浙江省5地市耐多药结核病防治策略效果评价

Evaluation on multi-drug resistant tuberculosis control strategies in 5 pilot cities in Zhejiang province

  • 摘要: 目的评估浙江省5个试点地市耐多药结核病防治策略实施效果,为今后耐多药结核病预防控制提供依据。方法对浙江省杭州、湖州、绍兴、衢州与丽水5个地市共7 140例涂阳肺结核患者进行耐多药筛查,按照统一的技术方案对耐多药肺结核患者进行治疗与管理,运用描述性统计和单因素分析方法对试点地区登记的耐多药结核患者发现、治疗等监测数据进行分析。结果试点地区在评估时间段内共确诊耐多药结核病患者537例,351例患者进行了标准耐药治疗;患者6个月末培养转阴率为71.4%,完成疗程患者治愈率为71.0%;复治失败和初治失败肺结核患者药敏检出耐多药比例分别为67.4%与52.4%,而新涂阳患者检出比例为2.5%;患者未进行耐药治疗主要原因为原方案治疗有效26.2%、迁出或失访20.6%、缺乏有效治疗方案19.8%、治疗前死亡15.1%。结论浙江省耐多药肺结核防治模式取得了一定效果,但患者纳入治疗比例较低,中断治疗比例偏高,副反应与远期疗效观察等问题需进一步研究解决。

     

    Abstract: ObjectiveTo evaluate the multi-drug resistant tuberculosis (MDR-TB)control strategies implemented in 5 pilot cities in Zhejiang province,and to provide evidence for further MDR-TB control.MethodsTotally 7 140 smear positive TB patients from 5 cities (Hangzhou,Huzhou,Shaoxing,Quzhou,and Lishui)were screened and tested.The MDR-TB cases diagnosed were treated and followed with standard procedure.Statistical description and univariate analysis were used to analyze MDR-TB case-finding and treatment data collected.ResultsDuring the study period,537 MDR-TB cases were detected and 351 patients were treated with standard anti-MDR therapy.Totally 71.4%of the MDR-TB patients turned to culture-negative after finishing the first 6 months course.The cure rate of MDR-TB patients who finished the 2-year treatment were 71.0%.The detection ratio of drug sensitive test (DST)among the treated and retreated failure cases was 52.4%and 67.4%,respectively.The detection ratio of new smear positive cases was 2.5%.The major reasons for the MDR-TB patients who were not enrolled and treated with standard anti-MDR therapy were successful former treatment regime (26.2%),migration or default (20.6%),treatment deficiency (19.8%)and deaths before enrolment (15.1%).ConclusionThe MDR-TB control strategies applied in Zhejiang province were proved to be practical and efficient.However,the problems such as low enrolment rate,high treatment suspending proportion,side effect,and long-term treatment outcome need to be studied.

     

/

返回文章
返回