上海市徐汇区第五轮全球基金流动人口结核病控制项目实施效果评价

目的 分析和评价上海市徐汇区第五轮全球基金流动人口结核病控制项目（简称“基金项目”）执行后的实施效果.方法 对比分析2007年10月1日基金项目执行前1年和2010年6月30日项目执行了2年零9个月（33个月）后（根据项目实施年度分为3期,即项目1期、项目2期第1年、第2年）流动人口疑似肺结核患者、转诊追踪和结核病患者治疗转归及管理等情况,比较基金项目执行前后重点指标（包括疑似患者初诊数、总体到位率、新涂阳肺结核患者2个月末痰菌阴转率、新涂阳患者治愈率、活动性患者完成疗程率等）的定基比增长率和环比增长率,并对项目执行后跨区域患者管理情况进行分析.结果 徐汇区基金项目执行33个月后与执行前相比,项目重点指标定基比增长率执行1期、2期第1年和第2年均增长明显,疑似患者初诊数的定基比增长率分别为12.29％（813 724）/724]、48.20％（1073-724）/724）]和59.81 ％（1157-724）/724];总体到位率的定基比增长率分别为3.58％（91.14-87.99）/87.99]、2.45％（90.15-87.99）/87.99]和7.96％（94.99-87.99）/87.99];新涂阳肺结核患者治疗后2个月末痰菌阴转率的定基比增长率分别是43.71％（82.46-57.38）/57.38]、55.93 ％（89.47 57.38）/57.38]和49.37％（85.71-57.38）/57.38];新涂阳患者治愈率的定基比增长率分别是31.10 ％（85.96-65.57）/65.57]、48.50％（97.37-65.57）/65.57]和48.15％（97.14-65.57）/65.57];活动性患者完成疗程率的定基比增长率分别是30.18％（90.32-69.38）/69.38]、40.56％（97.52-69.38）/69.38]和40.31％（97.35-69.38）/69.38].结论 全球基金项目实施后徐汇区流动人口结核病的防治效果明显,使流动人口患者受益,也提升了徐汇区结核病整体防治和管理水平.

Effectiveness evaluation of the global fund program to fight tuberculosis aimed at floating population in Xuhui district in Shanghai

Objective To evaluate the effectiveness of the fifth round of the global fund （GF） program to fight tuberculosis （TB） aimed at floating population in Xuhui district in Shanghai from October 1st, 2007 to June 30th, 2010. Methods The situation of referral and tracing of the TB suspects in floating population, the treatment outcomes and management of TB cases in floating population before and after the program were compared. The key indicators on TB control by the increasing proportion of fixed base ratio and chain ratio before October 1st, 2007 i. e. the fund conduct one year with the key indicators after the fund conduct 2 years and 9 months （total for 33 months） from October 1st, 2007 to June 30th, 2010 （the program executing years were divided into 3 stages, i. e. stage ~_ , the first year of stage Ⅱ , the second year of stage Ⅱ ） were compared as well. These indicators included the number of the registration of TB suspects, overall arrival rate, sputum negative conversion rate of new smear positive cases at 2 months of treatment, cure rate of new smear positive patients, treatment completion rate of active patients. The management situation of the cross-regional patients was also analyzed. Results The annual increas- ing proportion of fixed base ratio of the key indicators increased obviously in stage Ⅰ , the first year of stage Ⅱ and the second year of stage H. Those of the number of the registration of TB suspects were 12.29% （（813--724）/724）, 48.20%（（1073--724）/724） and 59.81% （（1157--724）/724）. Those of overall arrival rate were 3.58%（（91.14-- 87.99）/87.99）, 2.45%（（90.15 87.99）/87.99） and 7.96%（（94.99--87.99）/87.99）. The increasing proportion of fixed base ratio of sputum negative conversion rate of new smear positive cases at 2 months of treatment were 43.71%（（82.46--57.38）/57.38）, 55.93% （（89.47--57.38）/57.38） and 49. 370/00 （（85.71--57.38）/57.38）. Those of cure rate of new smear-positive patients were 31.10% （（85.96 -- 65.57）/65. 571）, 48.50% （（97.37 -- 65.57）/65.57）and 48.15%（（97.14--65.57）/65.57）. Those of treatment completion rate of active patients were 30.18%（（90.32 69.38）/69.38）, 40.56% （（97.52--69.38）/69.38）and 40.31%（（97.35 69.38）/69.38））. Conclusions Effectiveness of the global fund program to fight tuberculosis for the floating population was obvious. The execution of GF project has not only benefited the floating population, but also effectively improved the routine and overall level of TB control and management in Xuhui district.