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中国防痨杂志 ›› 2008, Vol. 30 ›› Issue (6): 524-527.

• 论著 • 上一篇    下一篇

加强转诊和追踪以提高结核病发现率的实施性研究

白丽琼1;杨华林1;简学武2;何新国1;陈有芳1;唐益1;成诗明3;肖水源4   

  1. 1 湖南省结核病防治所 长沙 410013;2 湖南省卫生厅疾病控制处 长沙 210008;3 中国疾病预防控制中心结核病预防控制中心 北京 100050;4 中南大学公共卫生学院 长沙 410008
  • 出版日期:2008-06-10 发布日期:2011-11-03
  • 基金资助:
    FIDELIS项目资助(2003_fid_1_002

Operational research on increasing TB case detection through intensive referral and tracing in Hunan province

Bai Liqiong1,Yang Hualin,Jian Xuewu,et al.   

  1. 1.Hunan Institute for Tuberculosis Control,Changsha 410013,China
  • Online:2008-06-10 Published:2011-11-03

摘要: 目的通过加强综合医院与结核病防治所之间合作和病例转诊与追踪,探讨提高结核病人的发现水平方法。方法采取非概率抽样法抽取湖南省邵阳、常德和怀化3市所辖的38个县(区)作为研究现场。结合全省实际,制订切实可行的结核病人转诊追踪实施规范并组织实施。比较项目前后1年及覆盖地区与非覆盖地区间结核病转诊率、追踪率,新涂阳病人发现率和登记率。结果在38个实施县(区)的126家县级综合性医疗机构中,124家平均每月转诊10例结核病可疑症状者或结核病患者到结核病防治机构。与项目前1年比较,病人的登记率增长了102.1%;综合医院疑似结核病例或结核病人转诊率增加了5倍;新涂阳肺结核患者登记率从27.12/10万增加到57.71/10万,且明显高于非项目县(38.77/10万)。结论加强结核病转诊和追踪是提高病人发现率的有效措施。行政干预和激励机制是这一有效措施得以实施的保证。

关键词: 结核, 肺/预防与控制

Abstract: Objective To explore a feasible approach to increase case detection of tuberculosis through intensive referral and tracing of TB suspects and patients between hospital and TB dispensary.Methods An operational research was conducted in 3 cities and 38 jurisdiction counties sampled by non-probability,and a strategic referral and tracing system between hospitals/clinics and TB dispensary was developed upon the local situation in Hunan province of China.One-year monitoring of referral,tracing and diagnosis of TB suspects and cases data was used to assess the outcomes of the project implementation.Comparisons of the case detection and notification of new smear-positive tuberculosis were made between the project year and the previous year,project areas and non-project areas.Results Among 126 public general hospitals/clinics in 38 project counties,124 hospitals referred a mean of 10 TB suspects and cases to TB dispensary monthly.Comparing with the previous year,the initial consultation rate of TB suspects increased 102.1%;the referral of TB suspects from hospitals/clinics to TB dispensary increased 5 times a total of 10596 new smear-positive PTB cases were identified and the notification of new smear positive PTB increased by 112.9% from 27.12/100000 in the previous year to 57.71/100000 in the project year,a significantly higher than non-project area,whose notification was 38.77/100000.Conclusions Intensive referral and tracing of TB suspects and patients between hospital and TB dispensary is a feasible and effective approach to increase case detection.Strengthening administrative intervention and incentive mechanism are essential to achieve the project objectives.

Key words: tuberculosis, pulmonary/prevention and control