甘肃省边远贫困地区肺结核病人DOT管理现状调查分析

中国防痨杂志 ›› 2009, Vol. 31 ›› Issue (1): 22-25.

甘肃省边远贫困地区肺结核病人DOT管理现状调查分析

高巧芬；甘培尚；张岚；司红艳；杨枢敏；冯菊英

甘肃省疾病预防控制中心结核病防治所兰州 730020

出版日期:2009-01-10 发布日期:2011-11-03

Analysis on the status of DOT management in poor and remote area in Gansu province

Gao Qiaofen, Gan Peishang, Zhang Lan, Si Hongyan, Yang Shumin, Feng Juying

National Center for Tuberculosis Control and Prevention Gansu CDC, Lanzhou 730020, China

Online:2009-01-10 Published:2011-11-03

摘要/Abstract

摘要： 目的调查边远贫困地区肺结核病人DOT管理现状,了解边远贫困地区肺结核病人DOT管理中存在的问题和影响因素。方法随机抽取2个人口在40万以上的国家级贫困县查阅2005年2006年的季报表、年报、病案等归档材料进行汇总、分析，并抽取这2个县距县城10km以上的12个乡，对2005年登记管理化疗结束的涂阳肺结核病人采用现场问卷方式调查和追访，了解病人DOT管理情况及影响因素，分析评价边远贫困地区肺结核病人DOT管理质量。结果有效的109例涂阳病人中直接面视服药率为19.3%，75.2%的病人为自服药；治愈率为41.3%，完成疗程率为38.5%， 18.4%的病人因各种原因为不规则治疗；县、乡、村3级防痨人员由于人力、时间、经济等因素不能做到直接面视规律服药；影响病人服药依从性、疗程期间查痰多为主观因素，并与病人年龄、结核病知识知晓情况、督导管理质量和频次、药物不良反应相关。结论边远贫困地区肺结核病人的DOT管理质量情况不尽人意。探索适合远贫困地区实际情况，切实可行的病人DOT管理方法，是我省边远贫困地区实施DOT策略亟待解决的问题，同时提高病人对结核病防治知晓率是提高病人规律服药的重要措施之一。

关键词: 结核, 肺/预防和控制, 贫困区, 甘肃省

Abstract: ObjectiveTo investigate the status of DOT management in poor and remote area, and to identify the existing problems and the influencial factors of it. MethodsTwo counties with the population at 400000 or above were randomly selected in the remote and poverty counties in Gansu province. The quarterly and annual data in 2005 and 2006 were collected and analyzed. Twelve townships whose distance to county center was more than l0 km were selected to conduct questionnaire interview and follow-up survey among the smear positive PTB cases that have completed the treatment before 2005, which was designed to understand the DOTS management status and its influencial factors and to evalaute the quality of DOTS in poor and remote area. ResultsThe DOTS coverage of the 109 smear positive cases was 19.3%, and 75.2% patients was not covered by DOTS and took drugs by themselves; the cure rate was 41.3% and the completion rate was 38.5%, 18.4% of the total cases did not regularly take medicine. The low coverage of DOTS was mainly due to the insufficiency in human resource, time and financial support at county, township and village levels. The factors related with the drug intake and frequency of sputum examiniation included age, TB awareness, quality and frequency of DOTS, and side-effect. ConclusionsThe quality of DOTS management in poor and remote area is low. It is urgent to develop DOTS management Methods adaptable to the local situation in poor and remote area and to improve the TB awareness among various group in the poor and remote area.

Key words: pulmonary tuberculosis/prevention and control, poverty areas, Gansu province

高巧芬,甘培尚,张岚,司红艳,杨枢敏,冯菊英. 甘肃省边远贫困地区肺结核病人DOT管理现状调查分析[J]. 中国防痨杂志, 2009, 31(1): 22-25.

Gao Qiaofen, Gan Peishang, Zhang Lan, Si Hongyan, Yang Shumin, Feng Juying. Analysis on the status of DOT management in poor and remote area in Gansu province[J]. Chinese Journal of Antituberculosis, 2009, 31(1): 22-25.

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