论文部分内容阅读
背景﹕印度六个区的政府卫生机构。目的﹕估算咳嗽的发生率及比较咳嗽≥2周或≥3周的门诊病人涂阳结核病的发现情况。设计﹕由经过培训的卫生人员询问每一病人的咳嗽情况,咳嗽≥2周者进行痰显微镜检查。结果﹕在调查的55561例门诊病人中,咳嗽≥2周者2210例(4%),其中267例为涂阳结核病,而咳嗽≥3周者则为182/1370。31%病人无咳嗽主诉,涂阳可能性显著低于有咳嗽主诉者(各为45/680[7%]、222/1530[15%],P<0.001)。但在267例涂阳病人中占45例。如以咳嗽≥2周为痰显微镜检查筛选标准,估计在初级、二级卫生机构每天进行涂片检查各为8次与19次,如以咳嗽≥3周为标准则各为5次及12次。结论﹕认真询问门诊病人的咳嗽情况以及将咳嗽≥3周改为≥2周作为痰检的筛选标准可以显著提高涂阳结核病人的发现。但在全国实施此改变前需对其进行规划可行性评估。
Background: Government health agencies in six districts of India. PURPOSE: To estimate the incidence of cough and to compare the detection of smear-positive TB in outpatients with coughing for ≥2 weeks or ≥3 weeks. Design: Cough samples from each patient were asked by trained health personnel and sputum microscopies were performed on patients who coughed for more than 2 weeks. RESULTS: Of the 55,561 outpatients surveyed, 2210 (4%) had coughs for more than 2 weeks, of whom 267 were smear positive for tuberculosis and 182/1370.31% for patients who coughed for> 3 weeks without cough, The likelihood of smear-positive was significantly lower than those with cough (45/680 [7%], 222/1530 [15%], P <0.001 each). However, 267 cases of smear-positive patients accounted for 45 cases. Such as cough ≥ 2 weeks for sputum microscopy screening criteria, estimated in primary and secondary health institutions every smear each 8 and 19 times, such as cough ≥ 3 weeks as the standard were 5 and 12 times each . CONCLUSIONS: Serious interrogation of outpatients with cough and the conversion of coughing from ≥3 weeks to ≥2 weeks as a screening criterion for sputum testing can significantly improve the findings of smear-positive TB patients. However, a feasibility assessment of the planning needs to be carried out before this change is implemented across the country.