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目的评价周宁县世行贷款/英国赠款结核病控制项目实施9年的效果。方法对2002~2010年周宁县结核病防治相关资料进行分析。结果 2002~2010年累计接诊可疑肺结核病人3 981例,年均可疑者就诊率为2.30‰,因症就诊者占74.99%,转诊占22.21%,因症推荐占0.15%,其他占2.65%。2002~2010年累计登记活动性肺结核病人961例,其中新涂阳534例,复治涂阳97例,新涂阴330例。2002~2005年涂阳肺结核、新涂阳肺结核登记率呈上升趋势(P<0.05或0.01),2006~2010年均呈下降趋势(P<0.01)。治疗1年时平均治愈率,新涂阳病人为93.26%,复治涂阳病人为81.44%;死亡10例,病死率为1.58%。项目实施以来,避免5 770~8 655人感染肺结核病菌,减少289~433人发病,挽回82个健康生命,节约防治费用72.49~89.91万元,减少误工损失51.36万元,挽回DALY(生命质量调整年)6 081人年,减少GDP(地区生产总值)损失2 371.59万元。结论周宁县世行贷款∕英国赠款结核病控制项目实施效果明显,达到高发现率和高治愈率的目标。
Objective To evaluate the effectiveness of the 9-year implementation of the World Bank-financed Zhouning / UK Grants Tuberculosis Control Project in Zhouning County. Methods The data of tuberculosis control in Zhouning County from 2002 to 2010 were analyzed. Results A total of 3 981 cases of suspicious pulmonary tuberculosis were admitted during 2002-2010. The average annual visiting rate was 2.30 ‰. The rate of visiting patients was 74.99%, referral was 22.21%, suggestion was 0.15% and the others were 2.65% . A total of 961 cases of active pulmonary tuberculosis were registered from 2002 to 2010, including 534 cases of new smear positive, 97 cases of smear positive in retreatment and 330 cases of new smear negative. Between 2002 and 2005, the registration rate of smear-positive pulmonary tuberculosis showed an upward trend (P <0.05 or 0.01), and both showed a decreasing trend from 2006 to 2010 (P <0.01). The average cure rate at 1 year was 93.26% in new smear positive patients and 81.44% in smear positive patients in retreatment. The death rate was 10% and the case fatality rate was 1.58%. Since the implementation of the project, 5 770 ~ 8 655 people have been prevented from being infected with pulmonary tuberculosis bacteria, 289 ~ 433 people have been reduced, 82 healthy lives have been saved, 72.49 ~ 899,100 yuan have been saved in prevention and treatment, and 531,600 yuan have been lost in loss of labor due to loss of working time. DALY (Quality of Life Adjustment Year) 6 081 person-years, reducing GDP (regional GDP) loss of 23.7159 million yuan. Conclusion The implementation of the World Bank-financed / UK Grants TB Control Project in Zhouning County has achieved remarkable results, achieving the goal of high detection rate and high cure rate.