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目的调查分析既往及正在执行的结核病控制项目在改善中国流动人口结核病服务获得和利用方面所采取的相关政策文件和干预措施,并评价其效果和影响,为进一步开展结核病防治工作提供依据和建议。方法计算机检索MEDLINE、PubMed、CNKI、CBMdisc、万方学位论文全文数据库及VIP,纳入1988～2008年发表的关于流动人口结核防治工作的文献。同时采用非概率目的性抽样方法,在获得访谈对象知情同意后进行现场访谈。结果共检索到58篇文献,其中符合纳入标准的已发表文献8篇,未发表文献5篇,但其中仅有1篇为RCT,质量仅为B级。二次文献研究结果显示:我国目前对流动人口结核病防治采取的措施包括健康促进、提供激励机制、对病人实行督导管理等,且采取不同干预后病人知识知晓率、结核病治愈率均有所提高;但现场访谈结果显示,多数结核病人及疑似病例对于结核的防治知识及免费政策知晓不够,地区间结核病階治机构间没有有效的信息交流,致使流动人口追踪督导困难,结核病人的发现、治疗仍有待加强。结论现有针对流动人群的结核病防治研究中,缺乏高质量研究,因此难以对流动人口的结核病干预措施的效果做出客观、公正的评价;今后应开展专门针对流动人口结核病控制的大样本、多中心、高质量的RCT研究,为制定科学可行的干预设计方案提供依据。
Objective To investigate and analyze the relevant policy documents and interventions taken by previous and ongoing tuberculosis control programs in improving access to and utilization of TB services in floating population in China and evaluate their effects and impacts so as to provide basis and recommendations for further tuberculosis prevention and control work. METHODS: MEDLINE, PubMed, CNKI and CBMdisc were searched by computer, and the VIP articles of Wanfang Dissertation were included in the articles published in 1988 to 2008 on prevention and treatment of floating population tuberculosis. At the same time, non-probabilistic purpose sampling method was used to conduct on-site interview after obtaining the informed consent of the interviewees. Results A total of 58 articles were retrieved, of which 8 articles were eligible for inclusion and 5 were not published. However, only 1 of them was an RCT and the quality was only Grade B. The results of the second literature study show that the current measures taken to prevent and control tuberculosis in floating population in our country include health promotion, providing incentive mechanism and supervising and managing the patients. With the intervention of different interventions, the awareness of patient knowledge and the cure rate of TB increased. However, the results of field interviews showed that most TB patients and suspected cases did not have enough knowledge about TB prevention and control and free policies. There was no effective exchange of information among TB agencies in different regions, which led to the difficulty of tracing the supervision by floating population. The TB patients’ It needs to be strengthened. Conclusions There is a lack of high quality research on the prevention and treatment of tuberculosis among floating population. Therefore, it is difficult to make an objective and fair evaluation on the effect of tuberculosis intervention among floating population. In the future, a large sample of tuberculosis control should be carried out for migrants Center, high-quality RCT research, to provide a basis for the development of scientific and feasible intervention design.