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背景:印度新德里。 目的:评价公私结合项目(PPM)用于加强结核病(TB)控制的可行性,并确定其对病例发现、病例管理质量、治疗效果以及对病人就诊方便程度的影响。 设计:(1)通过查阅病历资料监测病人发现工作;(2)对私人开业者(PPs)治疗的病人进行队列分析;(3)通过填写调查表对病人及私人开业者进行调查。 结果:共检出 612 例病人,其中 168 例(27%)为新发涂阳病人。由于私人开业者的参与,新发病人的登记率增加了 47%,新发涂阳病人的登记率增加了29%。登记病人在诊断和效果评价时的痰菌检查率分别是 100%和 84%。私人开业者的新发菌阳病人治疗成功率为 81%,与公立卫生机构的 86%无显著性差异。95%的病人采用了全面监督化疗方式。 结论:本公私合作项目与修正国家结核病控制规程 (RNTCP)的推荐内容相一致,是在政府资助下完成的,并在实施过程中得到一些政府和私人组织的支持。通过实施本项目提高了病例发现率,接受私人开业者全面监督化疗病人的治疗效果同样也令人满意。
Background: New Delhi, India. PURPOSE: To evaluate the feasibility of PPTP for strengthening TB control and to determine its impact on case finding, the quality of case management, the efficacy of treatment and the ease of access to the patient. Design: (1) Monitor patient discovery by reviewing medical records; (2) Perform cohort analysis of patients treated with PPs; (3) Investigate patients and private practitioners by completing questionnaires. Results: A total of 612 patients were detected, of which 168 (27%) were newly smear-positive patients. Due to the involvement of private practitioners, the registration rate of new patients increased by 47% and the registration rate of newly smear-positive patients increased by 29%. The sputum examination rates of registered patients at diagnosis and evaluation of effects were 100% and 84%, respectively. The rate of successful treatment of newly diagnosed bacilli in private practitioners was 81%, with no significant difference from 86% in public health institutions. 95% of patients used a comprehensive monitoring of chemotherapy. Conclusion: This public-private partnership is in line with the recommendations of the National Code for Tuberculosis Control (RNTCP) amendment and is funded by the government. It is supported by some government and private organizations during the implementation. Through the implementation of this project to improve the case detection rate, the acceptance of private practitioners to fully monitor the therapeutic effect of chemotherapy patients is also satisfactory.