关键词: 结核, 缺少医疗服务, 卫生策略

Abstract: Objective To analyze the economic and geographic factors,which affect the rate of cases with limited access(LA) among the new smear positive(NSP) cases,and design relevant interventions to reduce the rate of cases with LA among the NSP cases.Methods The rate of cases with LA among the NSP cases in 36 counties of Hubei FIDELIS project area during Oct.2003-Sept.2004 was obtained by questionnaire survey.Chi-square test was conducted in analyzing the relationship among the rate of cases with LA among the NSP cases,GDP per capita,service semi-diameter of TB dispensary,and landform characteristics(plain,mountain,and hill).Results There is no difference of the rate of cases with LA among the NSP cases among different GDP pre capita groups(χ²=1,P＞0.2);there is difference of the rate of cases with LA among the NSP cases among the three groups of service semi-diameter of TB dispensary(χ²=8.236,P＜0.002);the rate of cases with LA among the NSP cases is higher in the group beyond 30km than the group of 25～30km(χ²=7.063,P＜0.05);the rate of cases with LA among the NSP cases is higher in the group beyond 30km than the group less than 25km group(χ²=7.469,P＜0.05);there is difference of the rate of cases with LA among the NSP cases among landform characteristics groups(χ²=8.800,P＜0.001);the rate of cases with LA among the NSP cases is higher in mountain area than in hill area(χ²=6.085,P＜0.05),the rate of cases with LA among the NSP cases is higher in mountain area than in plain area(χ²=4.5,P＜0.05).Conclusion More funds should be invested to the counties with larger geographic area and mountainous area to facilitate patients receiving health service and reduce the rate of cases with LA among the NSP cases.Geographic area and mountainous area should be the priority consideration as criteria for project support with economy and population in the next place.

Key words: Tuberculosis, With limited access to health care service, Public health strategy