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目的评价陕西省结核病防治“十二五”规划实施效果,探讨结核病防治工作存在的问题,为政府制定防治策略提供依据。方法按照《全国结核病防治规划》(2011—2015年)评估方案,使用全国统一调查表对全省“十二五”规划实施情况进行自查,结果统一录入数据库,并自上而下逐级进行复核。患者发现、追踪、治疗管理等数据来源于传染病直报系统、结核病专报系统。最终资料统一录入Epi Data 3.1软件进行汇总,利用SPSS 19.0进行统计分析,采用χ~2趋势检验分析变化趋势,以P<0.05为差异有统计学意义。结果各级政府均制定结核病防治“十二五”规划,5年共投入防治经费19 904.9万元。全省基本建立“疾控机构、定点医院、基层医疗卫生机构协调配合”的新型结核病防治管理模式。全省活动性肺结核报告发病率由2011年的67.81/10万下降到2015年的56.69/10万。5年共发现活动性肺结核106 639例,其中新涂阳患者23 285例,治愈21 923例,治愈率为94.15%。规划期间全省有效避免35万人受感染,挽回社会总价值200.4亿元。结论陕西省“十二五”规划实施取得显著成绩,政府重视,多部门合作机制建立,结核病防治服务体系健全,疫情明显下降。但防治能力、医防合作、耐药防治工作等需要进一步强化。
Objective To evaluate the implementation effect of TB control in the “Twelfth Five-year Plan” in Shaanxi Province and explore the existing problems in tuberculosis prevention and control work so as to provide basis for the government to make prevention and cure strategies. Methods According to the assessment plan of National Tuberculosis Prevention and Control Program (2011-2015), the national unified questionnaire was used to conduct self-examination on the implementation of the “Twelfth Five-year Plan” across the province, and the results were entered into the database and downloaded from top to bottom Level review. Data such as patient discovery, follow-up, treatment management and so on come from infectious diseases reporting system and tuberculosis reporting system. The final data were collected by Epi Data 3.1 software and analyzed by SPSS 19.0. The trend was analyzed by χ ~ 2 trend test, and the difference was statistically significant at P <0.05. Results The governments at all levels have formulated the “Twelfth Five-Year Plan” for tuberculosis prevention and control and invested a total of 1990.49 million yuan in prevention and control over the past five years. The province basically established a new type of tuberculosis prevention and control management mode of “disease control institutions, designated hospitals and primary health care institutions”. The incidence of active tuberculosis in the province dropped from 67.81 / 100,000 in 2011 to 56.69 / 100,000 in 2015. In 5 years, a total of 106 639 active tuberculosis cases were found, of which 23 285 were newly smear positive and 21 923 were cured. The cure rate was 94.15%. During the planning period, the province effectively prevented 350,000 people from being infected and saved 20.4 billion yuan of the total social value. Conclusion The implementation of the “Twelfth Five-year Plan” in Shaanxi Province has achieved remarkable results. The government attaches importance to the establishment of a multi-sectoral cooperation mechanism and the TB prevention and treatment service system is sound and the epidemic situation has obviously dropped. However, prevention and control, medical cooperation, drug control work need to be further strengthened.