深圳市全球基金耐多药结核病防治项目实施效果分析

目的分析自2006年10月—2014年6月,深圳市实施全球基金耐多药结核病防治项目的效果,以期为调整全市的耐多药结核病综合防控策略提供依据。方法从结核病信息管理系统及2006年10月—2014年6月深圳市全球基金耐多药结核病防治项目工作月报、季报和年度报表收集相关信息,分析全市耐多药结核病政策保障情况、体系建设情况、项目覆盖情况、病人发现情况、治疗情况等。结果在项目实施期间,成立了领导小组和技术指导小组,建立了工作机制、医疗保障和法律保障。建立MDR-TB三级防控网络、市区两级诊断平台、市区两级实验室网络。项目覆盖全市所有10个区和全市所有人群,包括户籍人口和流动人口。将MDR-TB的筛查对象扩大到所有涂阳肺结核患者,包括新涂阳和复治涂阳患者。项目实施期间,全市共发现MDR-TB患者607例,纳入项目治疗168例,成功治疗率高达70.2%。结论通过项目的实施,发现"传播"已成为全市耐多药结核病产生的主要原因,加上对流动人口耐多药结核病缺乏有效的控制手段,耐多药结核病疫情面临的形势十分严峻,迫切需要有效措施,以防止耐药结核病疫情进一步蔓延。

Implementation effect of global fund on multi-drug resistant tuberculosis control project in Shenzhen

Objective To evaluate the effect of implementation of global fund on multi-drug resistant tuberculosis (MDR-TB) control project in Shenzhen City from October 2006 to June 2014,so as to provide the evidence for adjusting the comprehensive prevention and control strategy of MDR-TB in the city.Methods The relevant data were collected from the tuberculosis information management system and the monthly,quarterly and annual reports of the global fund on MDR-TB project in Shenzhen City from October 2006 to June 2014,and the data were analyzed for the policy guarantee situation,system construction,project coverage,patient detection,and treatment.Results The leading group and technical steering group were established,and the work mechanisms,medical security and legal protection were established.The MDR three-level prevention and control network,urban two-level diagnosis platform,and urban two-level laboratory network were established.The project covered all the 10 districts and all the population in the city,including the household registration population and migrating population.The MDR screening targets were extended to all smear-positive pulmonary tuberculosis patients,including new smear positive and retreated smear-positive patients.During the period of the implementation of the project,607 MDR-TB patients were found,and of which 168 cases were included into the project treatment,and the success treatment rate was 70.2％.Conclusions Through the implementation of the project,we find that“communication” has become the main cause of MDR-TB in the city,and we also find the lack of effective control measures for MDR-TB in the migrating population.The situation of MDR-TB is very serious,and therefore,the effective measures are required urgently to prevent the further soread of drug-resistant TB.