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目的探索在红塔区重点人群中开展肺结核患者发现的最优方式,形成常态机制,促进结核病重点人群监测体系建设,为卫生决策者制定肺结核患者发现策略提供科学依据。方法对红塔区六个街道(乡)19个村委会6 130名65岁及以上老年人、糖尿病患者进行问卷调查、胸部X线检查、痰涂片、痰培养及Gene Xpert检查。结果 2015年1-9月期间,重点人群主动筛查,共检出活动性肺结核5例,检出率为81.57/10万,被动发现方式发现的活动性肺结核有79例,登记率为18.3/10万;重点人群筛查期间,65岁及以上老年人肺结核患者登记率较2014年同期提高52.7%。结论在重点人群中开展主动筛查是被动发现方式的有益补充;主动筛查与基本公共卫生服务项目结合起来,合理分配基本公共卫生服务经费,既提高了肺结核患者的发现水平,又能极大的缩减花费的成本,是符合红塔区实际的可在一定范围内推广的肺结核主动筛查方式。
Objective To explore the best way to detect tuberculosis patients in key population of Hongta district, form the normal mechanism, promote the construction of the monitoring system of key population of tuberculosis, and provide the scientific basis for health policy-maker to discover the strategy of tuberculosis patients. Methods Six hundred and thirteen elderly people aged 65 years and over with diabetes mellitus were surveyed, chest X - ray, sputum smear, sputum culture and Gene Xpert in 19 village committees in 6 streets (townships) in Hongta District. Results During the period from January to September 2015, major populations were actively screened. Five cases of active pulmonary tuberculosis were detected, with a detection rate of 81.57 / 100 000. There were 79 cases of active pulmonary tuberculosis found by passive finding with a registration rate of 18.3 / 100,000; During the key population screening, the registration rate of pulmonary tuberculosis patients aged 65 and above increased by 52.7% over the same period of 2014. Conclusion Active screening in the key population is a useful supplement to passive detection. Proactive screening combined with basic public health services, rational allocation of funds for basic public health services, not only improve the level of detection of tuberculosis patients, but also greatly The cost of curtailment is in line with Hongta District, the actual promotion of tuberculosis within a certain range of active screening methods.