关键词: 结核, 分子诊断技术, 卫生服务研究, 总结性报告

Abstract: Objective To analyze the effect of the diagnosis process with molecular biology detection technology on the pulmonary tuberculosis case finding after the third phase of the “China National Health and Family Planning Commission-Bill and Melinda Gates Foundation Tuberculosis Prevention and Control Cooperation Project” (referred to as the “China-Gates Project Phase Ⅲ”) ending in Jilin Province. Methods Data of Mycobacterium tuberculosis detection and its drug resistance by using diagnostic process containing molecular biology detection technology in persons with suspected tuberculosis symptoms registered in all designated tuberculosis medical institutions in Jilin Province in 2019 were retrospectively collected and analyzed after finishing the third phase of the China-Gates Project. Results A total of 10278 (18.36%) suspected active pulmonary tuberculosis patients were identified by the molecular biology testing process among 55983 persons with suspected pulmonary tuberculosis symptoms, of which 3895 were smear positive and 6383 were smear negative. The proportion of Mycobacterium tuberculosis tested by using molecular biology technology was 98.35% (8885/9034), with detection rate being 54.25% (4820/8885). Among them, the proportion of Mycobacterium tuberculosis detected in smear-negative patients and the detection rate were 97.67% (6234/6383) and 35.15% (2191/6234), respectively, and another 13 tuberculosis patients were culture-positive. A total of 6099 pathogenic positive tuberculosis patients were identified, with a pathogenic positive rate of 59.34% (6099/10278), and all received molecular biology rapid drug-resistance testing. Detection rates of rifampicin resistance and multidrug resistance were 17.02% (1038/6099) and 6.48% (395/6099) among all pathogenic positive tuberculosis patients. In initial and retreated tuberculosis patients, rifampicin resistant rates were 11.37% (594/5222) and 50.63% (444/877), and multidrug resistant rates were 4.00% (209/5222) and 21.21% (186/877), respectively. Conclusion The third phase of the China-Gates Project in Jilin Province comprehensively promoted the new diagnostic process containing molecular biology technology, which significantly increased the pathogenic positive rate of suspected pulmonary tuberculosis patients and the detection level of rifampicin-resistant patients.

Key words: Tuberculosis, Molecular diagnostic techniques, Health services research, Consensus development conference