新疆世行贷款/英国政府赠款中国结核病控制项目(2002—2009年)实施效果分析

目的分析新疆世行贷款/英国赠款中国结核病控制项目的实施效果,提出新疆自治区结核病控制工作可持续发展建议,为制定2011—2020结核病规划提供科学依据。方法根据项目终期评估调查表,收集分析全区96个县市2002—2009年相关资料,汇总分析。结果通过项目的实施,全面推行了现代结核病控制策略(DOTS),积极发现和治愈传染性肺结核。(1)实现了肺结核病人的高发现率。涂阳肺结核病人的登记率逐年提高,从2002年的52.03/10万提高至2005年的89.38/10万,2002—2009年累计完成项目涂阳病人发现指标的110%。(2)98%以上的传染性肺结核落实了免费治疗和管理,初治涂阳病人治愈率达到94.7%,治疗成功率为96.3%。复治涂阳病人治愈率达到91.4%,治疗成功率为94.7%。(3)2002—2009年项目执行期间,累计免费治疗涂阳肺结核病人78 782例,共计为全区广大农牧民节约医药费用6亿多元。结论世行贷款结核病控制项目实施促进了结核病规划目标实现,达到了高发现率高治愈率的控制目标,取得了显著社会效益和经济效益。

Effect analysis of the WB/DFID TB control project in Xinjiang Uygur Autonomous Region, 2002-2009

Objective To analyze the implementation effect of the WB/DFID TB control project in Xinjiang Uygur Autonomous Region,and provide recommendations for sustainable development of regional TB control work,and provide evidence base for next ten years plan development.Methods According to the forms of the final evaluation,related information of whole 96 counties in Xinjiang were collected and analyze.Result The implementation of project fully promoted the expansion of DOTS strategy,improvement of active case detection and cure rate of infectious pulmonary tuberculosis（PTB） patients.（1） Achieved high case detection rate of pulmonary tuberculosis patients.The registration rate of smear-positive TB patients increased year by year from 52.03/100000 in 2002 to 89.38/100000 in 2005.The number of smear positive PTB patients detected from 2002 to 2009 reached 110% of cumulative case detection target during this period.（2） Achieved high cure rate.More than 98% of infectious PTB patients received free treatment and management.Cure rate and treatment success rate for new smear positive cases were 94.7% and 96.3%,91.4% and 94.7% for retreatment smear positive cases.（3） Achieved significant social benefits.From 2002 to 2009,a total of 78782 cases of smear-positive TB cases received free treatment.A large number of healthy people were protected against TB disease.National TB policy on free examination and promotion of outpatient TB service saved 600 million RMB of medical costs for vast farmers and herdsmen in whole region.Conclusion The implementation of the WB/DFID TB control project in Xinjiang Uygur Autonomous Region promoted the achievement of NTP goals,reached high case detection and cure rate,achieved remarkable social and economic benefits.TB prevention and control work still has a long way to go.Therefore there is a need to establish a sustainable long term mechanism.