共查询到20条相似文献,搜索用时 0 毫秒
1.
Y Y Wang T Liabsuetrakul V Chongsuvivatwong P Pungrassami C Y He L J Ren H Z Yang 《The international journal of tuberculosis and lung disease》2007,11(12):1345-1351
OBJECTIVE: To assess adherence to intermittent directly observed treatment (DOT) during the 2-month intensive phase of tuberculosis (TB) treatment in south-west rural China. DESIGN: A cross-sectional study was conducted in Simao Prefecture, Yunnan Province, China. One hundred and thirty new TB patients registered under DOTS and treated during the 2-month intensive phase and their observers were separately interviewed at their homes using structured questionnaires. Numbers of packs of TB drugs were checked on the spot. RESULTS: Of 130 visits, the same percentage (3.1%) of patients and their observers reported missing > or =2 consecutive weeks of treatment (prevalence-adjusted kappa = 0.94). The percentages who missed > or =20% of the packs, as reported by patients and observers, were 3.8 and 2.3, respectively (prevalence-adjusted kappa = 0.969). According to the pill count, nine patients (7%) had missed > or =20% of the packs, 10 had over-consumed TB drugs and two had lost respectively five and six packs. Eight of the 10 who had over-consumed had done so due to confusion in the days of the month, and two because they wanted a quicker recovery. CONCLUSIONS: Intermittent regimens in China need to be more carefully monitored to avoid over-consumption of anti-tuberculosis drugs in addition to non-adherence due to under-consumption. 相似文献
2.
Tang Shenglan Wang Lixia Wang Xuejing Squire S. B 《中国防痨杂志》2003,25(Z1):24-24
Objectives: To examine if rapid economic growth in 1990s in China has had any impact on TB prevalence in the poor provinces with or without a substantial TB control project. 相似文献
3.
Modeling the economic benefits of better TB vaccines. 总被引:1,自引:0,他引:1
OBJECTIVE: To describe the economic benefits of a better tuberculosis (TB) vaccine by modeling prevented TB medical spending and lost productivity throughout the world. DESIGN: One model is based on benefits obtained from reducing the impact of TB on health spending. An alternative model is based on minimizing the impact of TB on health spending and lost productivity due to death and disability. Both models are applied to various world populations based on secondary data. RESULTS: In terms of avoided medical spending, preventing 100% of the TB risk in a single individual is estimated to be worth from $38 for males in formerly socialist countries to S0.23 for children in Asia. More than 1 billion people would reckon their expected medical savings to exceed $25.00 if they received a 75% effective vaccine of 10 years' duration. Preventing lost productivity is worth substantially more throughout the world. CONCLUSIONS: Improved TB vaccines would be of substantial immediate financial value to most of the populations of the world, including the poorest. The scientific uncertainties surrounding the development of a better vaccine could be a larger obstacle than investor uncertainty over whether a vaccine would be profitable. 相似文献
4.
目的 分析临沂市实施世界银行贷款结核病控制项目 10年的成本 -效益。方法 对1992—2001年临沂市世界银行贷款额度、地方配套经费使用与病人发现、治疗情况进行分析。结果 10年利用世界银行贷款 551.87万元,地方配套经费 775.74万元,共计 1327.61万元,治愈涂阳肺结核病人 21440例。减少结核菌感染 21.44~32.16万人。减少肺结核传染源发生 1.2~1.8万人。节约治疗资金 2859.66万元。减少治疗误工费 1908.37万元。因减少活动性肺结核的发生而避免经济损失 1948.00~4421.99万元。结论 临沂市 10年世界银行贷款结核病控制项目成效显著,使21.44~32.16万人免受结核菌感染,减少传染源发生 1.072~1.608万人。共投入资金 1327.61万元,减少或避免了各种费用约 7715.82~9189.81万元。世界银行贷款结核病控制项目是一项投入少,经济效益和社会效益巨大的疾病控制项目。 相似文献
5.
Objective: To estimate the direct and indirect costs of chronic diseases attributed to smoking and exposure to secondhand smoke (SHS) in a given year (2011) in rural southwest China. Methods: A prevalence-based, disease-specific attributable-risk approach was used to estimate the economic burden of chronic diseases attributable to both smoking and exposure to secondhand smoke (SHS). A cross-sectional questionnaire survey of 17?158 consenting adults aged ≥18 years was used to derive prevalence of smoking and exposure to SHS, as well as direct and indirect costs of chronic diseases. Results: In the study population, the prevalence rates of smoking and exposure to SHS are 73.1 and 38.2% for males and 1.4 and 43.4% for females, respectively. The total costs of illness are $25.85 million for COPD, $18.80 million for asthma, $37.25 million for CHD, $17.91 million for stroke, $264.35 million for hypertension and $17.11 million for peptic ulcer. The estimated costs attributable to smoking and exposure to SHS are $95.51 million and $79.35 million, accounting for 7.15 and 5.94% of local healthcare costs, respectively. Of the total costs of tobacco, direct costs and indirect costs are $94.66 million and Objective: To estimate the direct and indirect costs of chronic diseases attributed to smoking and exposure to secondhand smoke (SHS) in a given year (2011) in rural southwest China. Methods: A prevalence-based, disease-specific attributable-risk approach was used to estimate the economic burden of chronic diseases attributable to both smoking and exposure to secondhand smoke (SHS). A cross-sectional questionnaire survey of 17?158 consenting adults aged ≥18 years was used to derive prevalence of smoking and exposure to SHS, as well as direct and indirect costs of chronic diseases. Results: In the study population, the prevalence rates of smoking and exposure to SHS are 73.1 and 38.2% for males and 1.4 and 43.4% for females, respectively. The total costs of illness are $25.85 million for COPD, $18.80 million for asthma, $37.25 million for CHD, $17.91 million for stroke, $264.35 million for hypertension and $17.11 million for peptic ulcer. The estimated costs attributable to smoking and exposure to SHS are $95.51 million and $79.35 million, accounting for 7.15 and 5.94% of local healthcare costs, respectively. Of the total costs of tobacco, direct costs and indirect costs are $94.66 million and $0.85 million for smoking, and $78.22 million and $1.36 million for exposure to SHS. Smoking contributes more cost of illness than exposure to SHS in men, whereas exposure to SHS contributes more cost of illness than smoking in women. Conclusions: Smoking and exposure to SHS produce substantial economic burden as well as have a considerable public health impact in rural southwest China. 相似文献
6.
Cai Le Shu Zhankun Dong Jun Zhao Keying 《Tropical medicine & international health : TM & IH》2012,17(12):1544-1551
Objective To estimate the economic burden of hypertension in a given year in rural Yunnan Province of China, including direct, indirect and intangible costs. Methods A prevalence‐based cost‐of‐illness method was used to estimate the economic burden of hypertension. Data on participants’ demographic characteristics, inpatient hospitalisation expenditures, outpatient visit expenditures, self‐medication costs and indirect costs related to hypertension were collected from a cross‐sectional health examination and questionnaire survey, involving 9396 consenting individuals aged ≥18 years and 3500 households. Blood pressure (BP) levels were determined from the average of three BP measurements. Years of life lost (YLL) because of hypertension was estimated using medical death certificates. Results The overall prevalence of and YLL/1000 population because of hypertension was 24.8% and 1.5 years for the survey population, respectively. Mean unit direct medical costs, direct non‐medical costs, morbidity costs, mortality costs, intangible costs and cost of illness were estimated to be $467.2, $20.1, $23.5, $8265.1, $417.4 and $9393.3, respectively. The total cost of hypertension was estimated to be $231.7 million. Direct costs represented the largest component of economic cost of hypertension. On average, males had higher overall direct, indirect and intangible costs of hypertension than females. Both indirect and intangible costs decreased with age, whereas direct costs increased with age. The incidence of household catastrophic health payment and household impoverishment because of hypertension was 8.9% and 4.1%, respectively. Conclusions Hypertension inflicts a considerable economic burden upon individual households and society as a whole in Yunnan Province, China. 相似文献
7.
电话督导与传统督导对湖南农村肺结核患者干预效果的比较 总被引:1,自引:0,他引:1
目的 通过比较电话督导和传统督导对涂阳肺结核患者干预效果的影响,探讨电话督导在结核病防治管理中推广应用的可行性。方法 采用整群随机抽样的方法,将县村两级医师电话督导、县级医师电话督导、村级医师电话督导和传统督导4种不同干预模式完全随机地分配到4个抽样县;研究共纳入涂阳肺结核患者546例,其中3个电话督导组(即干预1组、2组、3组)分别有173、124和160例,传统督导组(即对照组)89例,对各组纳入的结核病患者随访观察1年;对4个抽样县的主要指标进行样本率和构成比分析。结果 与对照组治愈率为82.0%(73/89)相比,干预1组肺结核患者的治愈率升高,为94.2%(163/173),差异具有统计学意义(χ2=10.052,P<0.05);干预1组肺结核患者的不规律服药率为1.2%(2/173),低于对照组的11.2%(10/89),且差异具有统计学意义(χ2=16.120,P<0.05);干预2组肺结核患者的不规律复查率为5.6%(7/124),对照组为18.0%(16/89),差异具有统计学意义(χ2=9.153,P<0.05)。结论 对肺结核患者进行电话督导有助于提高肺结核患者服药治疗的依从性及治疗效果,适合于在结核病控制项目中推广。 相似文献
8.
P N Ngang J Ntaganira A Kalk S Wolter S Ecks 《The international journal of tuberculosis and lung disease》2007,11(10):1108-1113
SETTING: Two southern provinces of Rwanda, Butare and Gikongoro. OBJECTIVES: To identify beliefs and popular perceptions on cough and tuberculosis (TB) in rural Rwanda and determine how they shape health-seeking behaviour. METHODS: Eight focus group discussions, 21 key informant interviews and 12 illness narratives were conducted between May and June 2004. STUDY POPULATION: TB patients, community members, traditional healers and health workers. RESULTS: There is wide use of herbal treatment for chronic cough in Rwanda. Patients seek conventional care when alternative treatment options fail or when severe symptoms such as shortness of breath, bloody sputum and weight loss appear. There are several local illnesses associated with chronic cough, with different alternative treatments. TB symptoms are often mistaken for the acquired immune-deficiency syndrome (AIDS). Identified causes for cough-related illnesses can be classified as biomedical (germs, internal body dysfunction and worms), environmental (seasonal changes and dust), cultural (inheritance), socio-economic (hard work, malnutrition and tobacco), and supernatural (witchcraft). Three health-seeking end points emerge for chronic cough: home care, health facility and the traditional healer. Healers in some areas, however, believe TB due to witchcraft can only be treated traditionally. CONCLUSION: This study unveils beliefs and treatment options for chronic cough in Rwanda, with important implications for TB control that should be addressed. 相似文献
9.
世界银行贷款/英国赠款中国结核病控制项目对凯里市结核病控制的影响 总被引:1,自引:1,他引:0
目的 评估世行贷款项目在凯里市结核病控制规划中的作用,为凯里市结核病防治提供建设性的意见。 方法 按照卫生部世行贷款结核病控制项目终期评估的统一要求,对资料进行收集、整理,调查表全部录入计算机进行分析。 结果凯里市2002年全面落实DOTS策略;2002-2008年发现的涂阳肺结核病人逐年增多,涂阳肺结核病人治愈率86.0%。新涂阳肺结核病人登记率逐年提高,从2002年的27.9/10万上升到2008年的45.10/10万。 结论 通过实施世行贷款结核病控制项目,促进了凯里市结核病控制规划目标的实现,建立了可持续发展机制,但结核病疫情仍然严重,结核病控制工作需进一步加强。 相似文献
10.
Mao-Sheng Ran Yue-Hui Yu Man-Man Peng Yu-Jun Liu Tian-Ming Zhang Shi-Hui Hu Die Zhou Hai-Jun Yang Xin Yang Wei Luo Chang-Cheng Liu Bo Liu Ke-Zhi Liu Ke Gong Chao-Hua Huang Tin Zhang Yong-You Yao Cecilia Lai-Wan Chan Meng-Ze Xiang 《Lancet》2018
Background
Little is known about the relationship between poverty and outcomes of severe mental illness (SMI) during a period of sustained rapid socioeconomic development. This study explored the relationship between poverty and outcomes of people with SMI in a 21-year longitudinal study in a rural area of China.Methods
Epidemiological surveys of mental disorders were conducted in May, 1994, and October, 2015, in the same six townships (total population 170?174 in 2015) in Xinjin County, Chengdu, China. Psychoses Screening Schedule together with key informant method for household survey and general psychiatric interview were administered to identify people with SMI (including schizophrenia, bipolar disorders, and major depressive disorder) according to International Classification of Mental and Behavioural Disorders-10 criteria.Findings
We identified 711 people with SMI aged 15 years and older in 1994 and 1042 in 2015. The annual net income per person in people with SMI was significantly lower in 1994 (1110·0 RMB) and 2015 (8420·1 RMB) (p<0·0001) than in the population of Xinjin (1330·0 RMB and 16856·0 RMB, respectively). The rate of having poor family economic status (<mean level) in people with SMI was significantly higher in 2015 (65·2%) than in 1994 (48·2%, p<0·0001). Poor family economic status was significantly associated with being male and unmarried, a lower number of family members, and lower rates of partial and full remission of SMI in 1994 and 2015 (p<0·05). Poor family economic status was also significantly associated with lower education level, lower rate of having a family caregiver, higher total score on the Positive and Negative Syndrome Scale, lower total score of Global Assessment of Functioning, and lower rates of medication in 2015 (p<0·05).Interpretation
Relative poverty has become more severe in people with SMI during the period of rapid socioeconomic development from 1994 to 2015 in China, and it is associated with poor outcomes of SMI. Prevention of the cycle of poverty and mental illness should be vital for Healthy China 2030. Targeted poverty alleviation programmes and community-based mental health care should be crucial for enhancing economic status and improving outcomes of people with SMI.Funding
The survey in 1994 was supported in part by China Medical Board of New York (92-557, principal investigator: MZX). The survey in 2015 was supported in part by Seed Funding Programme for Basic Research (Hong Kong University, 2014–2016, principal investigator: MSR), Seed Funding Programme for Applied Research (HKU, 2014–2016, principal investigator: MSR), Strategic Research Theme: Contemporary China Seed Funding (HKU, 2014–2016, principal investigator: MSR), Small Project Funding (HKU, 2014-2016, principal investigator: CLWC), and Mental Health Research in Chengdu, China (Department Matching Fund, 2015–2017, principal investigator: MSR). 相似文献11.
Floyd K 《Tuberculosis (Edinburgh, Scotland)》2003,83(1-3):187-200
This paper assesses the impact of economic studies on TB control during the period 1982-2002, with a focus on cost and cost-effectiveness studies. It begins by identifying broad categories of economic study relevant to TB control, and how economic studies can, theoretically, have an impact on TB control. The impact that economic studies of TB control have had in practice is then analysed through a systematic review of the literature on cost and cost-effectiveness studies related to TB control, and three case studies (one cost study and two cost-effectiveness studies). The results show that in the past 20 years, 66 cost-effectiveness studies and 31 cost studies have been done on a variety of important TB control topics, with a marked increase occurring after 1994. In terms of numbers, these studies have had most potential for impact in industrialized countries, and within industrialized countries are most likely to have had an impact on policy and practice related to screening and preventive therapy. In developing countries with a high burden of tuberculosis, far fewer studies have been undertaken. Here, the main impact of economic studies has been influencing policy and practice on the use of short-course chemotherapy, justifying the implementation of community-based care in Africa, and helping to mobilize funding for TB control based on the argument that short-course treatment for TB is one of the most cost-effective health interventions available. For the future, cost and cost-effectiveness studies will continue to be relevant, as will other types of economic study. 相似文献
12.
目的 探讨1999—2002年在福建省4个县农村开展结核病控制可持续发展工作。方法 结合WHO西太区项目,执行WHO提出的直接督导下短程化疗(DOTS)策略,规范组织管理与各项技术标准。结果 试点4年来,4个县共投入专项经费98万元,DOTS覆盖率100%;初诊病人就诊率1%,查痰率87.7%,阳性检出率32.4%,涂阳比例达58.2%;新发涂阳新登记率年均22.13/10万,涂阳新登记率年均28.93/10万,化疗督导率达89%,规则治疗率达98.6%,初、复治涂阳病人一年转归队列分析治愈率分别达92.7%、87.9%。结论 落实政府承诺、提高结防机构能力建设,标准化技术规范、落实归口管理、开展持久的健康教育等4个方面是农村结核病控制可持续发展的重要措施。 相似文献
13.
全国五省结核病与性别关系的研究 总被引:1,自引:0,他引:1
目的 了解全国5省登记报告肺结核患者的性别特征,促进结核病医疗卫生服务的可及性和公平性。 方法 利用描述性和比较性方法 ,分析全国5省登记报告肺结核患者的性别特征,以及不同性别肺结核患者的年龄、职业、治疗结局和诊断延迟的差异及有关的影响因素。结果全国5省登记报告肺结核患者男性高于女性,东部、南部和中部的男女性别比要高于西部和北部。大部分省份女性肺结核患者的平均年龄低于男性,职业中女性非农民所占比例较高,治疗结局不存在性别差异。不同性别涂阳肺结核患者的诊断延迟不存在差异,但5省之间存在差异,浙江平均为23-d,黑龙江为185-d;职业、年龄和性别是影响诊断延迟的重要因素。结论 登记报告的肺结核患者存在性别差异,而且不同性别肺结核患者的年龄、职业也存在着差异,但治疗结局和诊断延迟的差异无统计学意义。老年女性患者和农村务农女性获得结核病诊疗服务的可及性可能较差。 相似文献
14.
宁夏结核病控制的社会与经济效益评价 总被引:2,自引:0,他引:2
目的 分析评价宁夏中央经费支持下的结核病防治成本-效益.方法 对2001-2002年宁夏利用中央经费和地方结核病防治专项经费发现、治疗、管理病人情况进行分析.结果 两年来利用中央经费64万元和地方防治专项经费103.5万元,共计167.5万元,治愈初、复治涂阳肺结核病人1968例,共节省资金1922.3万元,预计减少的GDP损失和预计减少的收入损失分别为15467.1万元、1456.8万元;减少造成新的传染性病人2 952例,所避免GDP损失和避免收入损失分别27 042.4万元和25 433.3万元.结论 2年来宁夏利用中央和地方专项经费防治结核病成效显著.是一项投入少、经济效益和社会效益巨大的疾病控制项目,完全符合疾病控制与卫生经济学成本-效益的原则. 相似文献
15.
目的 分析评价宁夏中央经费支持下的结核病防治成本-效益。方法 对2001-2002年宁夏利用中央经费和地方结核病防治专项经费发现、治疗、管理病人情况进行分析。结果 两年来利用中央经费64万元和地方防治专项经费103.5万元,共计167.5万元,治愈初、复治涂阳肺结核病人1 968例,共节省资金1 922.3万元,预计减少的GDP损失和预计减少的收入损失分别为15 467.1万元1、456.8万元;减少造成新的传染性病人2 952例,所避免GDP损失和避免收入损失分别27 042.4万元和25 433.3万元。结论 2年来宁夏利用中央和地方专项经费防治结核病成效显著。是一项投入少、经济效益和社会效益巨大的疾病控制项目,完全符合疾病控制与卫生经济学成本-效益的原则。 相似文献
16.
17.
目的 探讨农村老年人尿失禁治疗情况及其所带来的疾病负担,为老年人尿失禁的干预提供依据. 方法 2007-2008年在天津市蓟县采用整群抽样的方法,以洇溜卫生院和大堼上卫生院所管辖的5个村庄的60岁及以上老年人为调查对象,共获有效问卷743份,对老年人尿失禁的一般情况、就诊情况和直接经济负担进行统计分析. 结果 743例中尿失禁248例(33.4%),曾在社区卫生服务中心或医院就诊者12例(4.8%),治疗方法均为药物治疗;其中患病1年内就诊l例、1~5年内就诊8例、5年或以上就诊3例.248例尿失禁患者中,227例(91.5%)未采取任何治疗措施,9例(3.6%)自行去药店买药服用、未就诊.治疗尿失禁的直接医疗费用为80~12 000元,其中100元以下的2例,100~1000元的2例,1001~5000元的7例,10 000元以上的1例. 结论 天津市蓟县老年人尿失禁患病率高,就诊率低,就诊患者承受较大的经济负担,应采取相应的干预策略预防老年人尿失禁. 相似文献
18.
对廊坊市农村地区结核菌素试验强阳性中小学生进行预防服药效果观察,异烟肼方案、异烟肼+利福喷丁方案服药人数分别为192人,未服药组为265人。1年内未服药组出现5例结核病病例,服药组未出现病例;异烟肼+利福喷丁方案较异烟肼方案疗程完成率高。预防服药对结核病的预防作用效果明显,联合、短程服药方案有待推广应用。 相似文献
19.
目的观察T淋巴细胞斑点试验(T-SPOT.TB)在结核病诊断中的临床应用价值。方法 205例疑似结核患者采用T-SPOT.TB试验、结核菌素试验(TST)和痰涂片检查,比较三种方法对结核诊断的灵敏性、特异性、假阳性率和假阴性率。结果 T-SPOT.TB试验的灵敏性明显高于TST试验和痰涂片检查(P<0.05);T-SPOT.TB试验的假阴性率明显低于TST试验和痰涂片检查(P<0.05)。结论 T-SPOT.TB具有更高的灵敏性,是结核筛检的有效试验方法。 相似文献
20.
R D Barker F J C Millard J Malatsi L Mkoana T Ngoatwana S Agarawal S de Valliere 《The international journal of tuberculosis and lung disease》2006,10(6):670-675
BACKGROUND: People in sub-Saharan Africa frequently consult traditional healers before reaching the government health services (GHS). This can lead to delays in starting effective anti-tuberculosis chemotherapy. To our knowledge, no studies have shown a direct relationship between visiting traditional healers, increased morbidity and death from TB. METHODS: All patients starting on anti-tuberculosis chemotherapy at a rural hospital in South Africa in 2003 were included in the study. TB nurses interviewed the patients and established how long they had had symptoms before treatment was started, whether they had visited traditional healers before coming to the hospital, their performance status and, later, whether they had died. RESULTS: Of 133 patients, those who attended a traditional healer took longer to access anti-tuberculosis chemotherapy (median 90 days, range 0-210) than those who went directly to the GHS (median 21, range 0-120). Patients who visited a traditional healer had worse performance status (P < 0.001), and were more likely to die (24/77 [31%] vs. 4/33 [12%], P = 0.04). CONCLUSION: Treatment delay due to visiting traditional healers can have dire consequences for patients with TB. Efforts are required to engage with health care practitioners outside the government sector to improve the prospects for patients with TB. 相似文献