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目的研究在经济较发达农村地区实施以社区线索筛查为基础主动发现结核病模式的可行性及其成本效果。方法对浙江省北部结核病控制项目(CIDA)县德清县抽取3个各1万人口以上的乡镇,每3个月一次进行连续三次慢性咳嗽患者入户筛查,对筛查阳性者(慢咳疑似者)进行进一步X线和痰检诊断。结果共筛查86618人次,发现结核病患者26例,其中涂阳病例7例;首次筛检效果优于随后的二次筛查;三次筛查每发现一例患者的费用分别为631、2397和1637元;在总筛查成本中,5．9％由结核病患者自负,35．9％由当地县财政负担。结论以社区线索筛查为基础发现结核病的筛查方式,有可能筛查出较多数量的潜在结核病例。在6个月内,随着筛查次数的增加,患者检出率降低,在既往发现工作较差的地区,能取得较高的检出率。该项筛查适合在经济较发达、结核病防治基础较差的农村地区有组织地开展。
Objective To study the feasibility and cost effectiveness of actively discovering tuberculosis model based on community clues screening in the economically advanced rural areas. Methods Three townships and townships with more than 10,000 inhabitants in Deqing County of Zhejiang Province’s northern CIDA counties were enrolled. Three consecutive patients with chronic cough were screened in every three months for screening. ) For further X-ray and sputum examination. Results A total of 86,618 person-times were found and 26 cases of tuberculosis were found, including smear-positive cases in 7 cases; the first screening was better than the second screening; the costs of one case of three screening were 631,2397 and 1637 yuan Of the total screening costs, 5.9% were self-reported by tuberculosis patients and 35.9% were financed by the local county. Conclusion Based on community census screening, it is possible to screen for a larger number of potential TB cases by finding a screening method for tuberculosis. Within 6 months, with the increase in the number of screening, the detection rate of patients decreased, in the past found that poor work area, can achieve a higher detection rate. This screening is suitable for organized development in rural areas where the economy is more developed and where tuberculosis control is poorly based.