新疆结核病防治机构实验室现况调查分析

目的了解新疆结核病防治机构实验室工作现况,为提高结核病实验室工作质量提供参考。方法采用横断面调查方法,采取普查的方式,对新疆1个自治区级实验室、14个地（州）级实验室、93个县（市）级实验室2011年痰涂片、细菌培养、药敏实验等工作的完成情况,实验室仪器设备等现况进行分析。结果实验室人力资源配置不均衡,92．6％的实验室只有1名工作人员,人员业务素质有待提高;必需仪器设备缺乏,三分之二以上实验室无法满足开展细菌培养、药敏实验的基本设备配置要求,难以适应日益提高的实验室检测需求。结论进一步加强结核病实验室人力资源建设,包括增加实验室工作人员和业务培训;加大实验室资金投入力度,尽快完成实验室硬件建设,以适应对实验室检测能力更高的要求。     

卫生部开展结核病防治规划实验室专项督导

为了解全国结核病控制规划进展情况，加强结核病实验室质量控制，根据卫生部疾病控制司的要求，中国疾病预防控制中心结核病防治临床中心国家结核病参比实验室组织人员于2005年9月至11月期间对八省进行了结核病防治规划实验室专项督导。     

浙江省结核病控制人力资源现状分析

目的了解浙江省市、县两级疾控机构中结核病控制人力资源现状。方法通过问卷调查取得第一手资料，对人员学历、职称、年龄及各岗位状况进行分析。结果市、县两级结核病控制人力资源在学历与职称构成的差别均有统计学意义；人力资源的技能掌握熟练程度较高；总体数量上不能满足结核病控制的需求；岗位设置不平衡。结论需要不断从数量上充实浙江省市、县两级结核病控制人力资源，以适应当前及今后的结核病控制需求。     

浙江省结核病控制人力资源现状分析

目的了解浙江省市、县两级疾控机构中结核病控制人力资源现状。方法通过问卷调查取得第一手资料,对人员学历、职称、年龄及各岗位状况进行分析。结果市、县两级结核病控制人力资源在学历与职称构成的差别均有统计学意义;人力资源的技能掌握熟练程度较高;总体数量上不能满足结核病控制的需求;岗位设置不平衡。结论需要不断从数量上充实浙江省市、县两级结核病控制人力资源,以适应当前及今后的结核病控制需求。     

浅论疾病预防控制机构老年人力资源的开发与利用

目的分析疾病预防控制机构老年人力资源的开发与利用,阐述老年人力资源开发利用问题产生的原因和疾病预防控制机构开发老年人力资源的必要性,并提出对策与建议。方法根据新疆拜城县疾病预防控制中心的人员编制、在岗人数、人员结构等人力资源基本情况,采用理论分析的方法。结果长期以来,在疾病预防控制机构中老年人力资源得不到开发和利用,造成了老年人力资源的闲置和浪费。结论在目前疾病预防控制机构现有人员短缺的情况下,对老年人力资源的开发和利用有重要的现实意义。     

开展耐多药肺结核规范化治疗管理的培训需求分析

通过分析中国全球基金结核病项目和中国卫生部盖茨基金会结核病项目（简称“中盖项目”）等耐多药肺结核项目实施中培训类别、频次、人员需求,提出将来国家实施耐多药肺结核规范化治疗管理各级的培训需求和经费测算的建议。研究结果显示,开展耐多药肺结核规范化诊疗工作必须开展的培训类别包括：临床技能中长期培训、实验室培训、耐多药肺结核防治管理工作方案培训和耐多药肺结核预防控制加强培训;省级需要培训的人员数量为10名,每个地市级需要培训的人员数量为48名,县级需要培训的人员数量为6名;平均每启动一个地市需要的培训经费约为125.4万元。本研究为今后全国范围内实施耐多药肺结核规范化治疗管理进行需求分析和经费测算提供了参考依据。     

吐鲁番地区疾病预防控制机构卫生人力资源分析

目的了解吐鲁番地区各级疾病预防控制机构卫生人才资源现状,为疾病预防控制机构人力资源合理配置、人力资源培训和考核提出建设性意见。方法收集2005年吐鲁番地区二县一市疾病预防控制中心及地区本级人力资源基本信息进行统计分析。结果吐鲁番地区各级疾病预防控制机构卫生人员以专科和中专为主,职称以中、初级为主,两级疾病预防控制中心卫生技术人员所学专业主要以医疗为主。结论吐鲁番地区疾病预防控制机构卫生人力资源分配不合理,地、县级疾病预防控制机构应拓宽用人渠道,有计划、有重点地引进高层次卫生专业人才,采取引进来、送出去的形式,加强继续医学教育,合理配置卫生人才资源。     

甘肃省结核病实验室资源现况分析

目的 了解甘肃省结核病控制体系实验室资源状况,提出改进建议。方法 共收集了包括甘肃省省级、14个市(州)级,85个县（区）级结核实验室共计100个实验室信息,统计130名实验员的数量、年龄、教育背景、技术职称、专业构成情况,以及实验室设备和当前的工作,并描述性分析其百分比。结果 33.1%(43/130)的实验员教育背景为中专及以下学历;非医学非检验专业人员占13.1%(17/130);兼职人员构成比为19.2%(25/130)。14个地市级实验室不能常规开展药敏试验,76个实验室缺乏生物安全柜,65个实验室缺乏恒温培养箱。结论 甘肃省结核病实验室人力资源建设和实验室设备需要加强。     

新疆疾病预防控制系统学校卫生人力资源现状分析

目的 了解新疆疾病预防控制系统中学校卫生人力资源配置现状,为学校卫生人才队伍的建设提供科学依据.方法 采用横断面调查方法,以新疆疾病预防控制机构中学校卫生相关科室作为调查对象,通过填写调查问卷,收集学校卫生人力资源相关信息,描述性分析人员的年龄、学历、专业、职称和工作情况等.结果 新疆地县两级110所疾病预防控制机构中,设置独立学校卫生科室的机构比例为5.45％,学校卫生专职工作人员占20.66％,正式人员占90.50％,以35～50岁为主,以公共卫生与预防医学类专业、专科及以下和本科和初级职称为主,半数以上学校卫生工作人员从事学校卫生工作的时间不足5年.结论 设置独立学校卫生科室的疾病预防控制机构较少,学校卫生工作人员整体配备不足、素质参差不齐;应加强全疆疾病预防控制机构学校卫生人才队伍的建设.     

白银市疾病预防控制机构人力资源配置分析

目的掌握甘肃省白银市各级疾病预防控制机构人力资源现状,为人力资源的合理配置提供科学依据。方法通过问卷调查收集截止2014年6月底白银市疾病预防控制机构在编、在岗人员基本信息,并进行分析。结果目前白银市每万人拥有疾病预防控制工作人员1.48人,配置低于国家及相关标准;年龄分布以35岁~为主,占39.45%;最终学历本科占44.92%,大专占30.08%,中专占21.48%;职称分布以初级居多、占52.74%,其次为中级占33.98%,高级仅占13.28%。结论白银市疾病预防控制机构人力资源配置不足,需进一步调整、优化人员队伍结构,提高人员整体素质。     

甘肃省乡级查痰点工作开展情况调查

目的了解甘肃省设立乡镇卫生院结核病痰涂片检查点(以下简称"乡级查痰点")以来(2005—2007年上半年)工作开展情况,为制定下一步乡级查痰点工作计划,规范乡级查痰点的工作提供科学依据。方法调查全省乡级查痰点基本情况、2005—2007年上半年乡级查痰点工作开展情况,分析查痰点存在的问题。结果甘肃省共设查痰点535个,痰检人员均为兼职。2005、2006、2007年上半年:痰检工作量为18 416、17 7989、242人份;发现涂阳病人1 001、936、395例;20%~33%的查痰点没有开展工作;年工作量大于50例的查痰点只占20%~24%,菌阳检出率4.3%~5.4%低于县级结核病细菌学实验室水平。结论甘肃省乡级查痰点在我省涂阳病人发现上做出一定的贡献,但乡级查痰点人员均为兼职、实验条件及安全防护差、工作开展不平衡、技术水平低。乡级查痰点工作现状应引起卫生行政部门及各级结核病防治机构的重视,应根据各地的不同情况,结合人口、县级工作需求、查痰点服务半径以及覆盖人口,减少查痰点的数量,并制定切实可行的措施,理顺工作程序,整合有限的资金,改善实验室工作条件,进一步规范乡级查痰点工作。     

我国结核病实验室诊断进展历程

实验室诊断是结核病诊断、治疗及预防控制过程中所必需的.我国结核病实验室网络逐步建立和完善,是国家结核病防治规划（NTP）的重要组成部分,在结核病防治工作中起着不可缺少的重要作用.实验室的质量保证工作应该得到足够的重视,从而更好发挥其在诊断、治疗方案制定和疗效评估中的作用.     

艾滋病患者的结核病诊治需与时俱进

艾滋病和结核病均为严重影响人类健康的传染性疾病.目前,艾滋病患者中结核病的诊治还存在诸多现实困难.为进一步推动艾滋病合并结核病的诊治工作,中国性病艾滋病防治协会HIV合并结核病专业委员会于2020年11月28日在上海成立.本文简要介绍了全球艾滋病合并结核病的流行概况,分析了艾滋病患者中结核病诊治存在的现实困境,并对HI...     

Tuberculosis as an occupational hazard for health care workers in Estonia.

SETTING: Tuberculosis incidence has been increasing in the Baltic states since the 1990s, accompanied by the emergence of drug resistance, including multidrug resistance (MDR). In this changing situation, the potential threat of nosocomial spread of tuberculosis to other patients and health care workers (HCW) has remained unrecognised. OBJECTIVE: To investigate the risk of tuberculosis in health care workers in Estonia. DESIGN: Cases of tuberculosis registered among HCWs from 1994 to 1998 were evaluated. The case records were analysed retrospectively and combined with bacteriological data including data on drug resistance. RESULTS: Sixty-seven HCWs (23 physicians, 23 nurses and seven laboratory technicians, 12 assistant nurses and two cleaners), all of whom tested negative for human immunodeficiency virus, were diagnosed as having active tuberculosis. The incidence of tuberculosis among HCWs (mean 91/100,000/year) was 1.5 to three times higher than in the general population. In a chest hospital in charge of regional tuberculosis care, the incidence was 30 to 90 times higher, and was highest among physicians. In 49 HCWs tuberculosis was confirmed by culture. Among these, drug resistance was detected in 23 (49%), 18 (38%) of whom had MDR tuberculosis. CONCLUSIONS: Health care workers, especially those working in a chest hospital where tuberculosis patients were treated, were found to be at an elevated risk of tuberculosis. MDR tuberculosis poses a particular threat which is difficult to combat.     

实验室检测技术在肺结核活动性判断中的应用进展

我国肺结核疫情十分严峻,临床上确诊活动性肺结核的“金标准”是结核分枝杆菌病原学检查,但对病原学阴性肺结核活动性的判断存在困难。作者介绍了目前用于病原学阴性肺结核活动性判断的实验室评价指标,包括结核分枝杆菌抗原、炎性和急性期反应标志物、免疫学指标、血液转录标志物等,指出了目前实验室检测技术在肺结核活动性判断及临床应用中存在的问题,并对其未来发展进行了论述与展望。     

Molecular epidemiology of tuberculosis in the Nord Department of France during 1995.

In order to determine the current situation and to evaluate the human to human transmission of Mycobacterium tuberculosis in Northern France, the genetic polymorphism of strains was studied by using IS6110 fingerprint. One hundred and fifty-eight cases of bacteriologically confirmed tuberculosis were analyzed. One hundred and twenty-six patients (82%) were infected with genetically different isolates and 28 isolates (18%) were grouped into 14 clusters. No risk factors for recent Mycobacterium tuberculosis infections such as age, HIV status, immigrants, living in big cities were identified. This study shows that there was no major epidemic situation of tuberculosis in Northern France in 1995. Tuberculosis was characterized by a low proportion of HIV positive patients and a high proportion of elderly patients.     

Occupational transmission of Mycobacterium tuberculosis to health care workers in a university hospital in Lima, Peru.

From November 1996 through March 1997, presumptive active pulmonary tuberculosis (TB) was detected in 44 health care workers (HCWs) at a university hospital in Lima, Peru. To further assess the magnitude of the outbreak and determine risk factors for occupational Mycobacterium tuberculosis transmission, we identified HCWs in whom active pulmonary TB was diagnosed from January 1994 through January 1998, calculated rates by year and hospital work area, and conducted a tuberculin skin test (TST) survey. Thirty-six HCWs had confirmed active pulmonary TB. The rate of TB was significantly higher among the 171 HCWs employed in the laboratory than among HCWs employed in all other areas. In multivariate analysis, the only independent risk factor for HCW M. tuberculosis infection in HWCs employed in the laboratory was the use of common staff areas. Very high rates of active pulmonary TB were detected among HCWs at this hospital, and occupational acquisition in the laboratory was associated with HCW-to-HCW transmission.     

深圳市福田区结核病分级诊疗和综合防治服务模式试点工作效果分析

目的 分析2017—2018年深圳市福田区实施结核病分级诊疗和综合防治服务模式试点工作后结核病防治能力建设情况以及患者发现、治疗管理情况,评估福田区试点工作取得的效果。方法 收集2017—2018年福田区实施结核病分级诊疗和综合防治服务模式试点工作后,福田区制定的政策制度、结核病防治体系建设、结核病新诊断技术应用、结核病患者管理新模式等资料,与实施结核病分级诊疗和综合防治服务模式试点工作前(2015—2016年)的数据进行对比分析。2015—2016年福田区慢性病防治院接诊的肺结核可疑者2093例,登记的肺结核患者772例;2017—2018年接诊的肺结核可疑者2319例,登记的肺结核患者690例。结果 2017年福田区制定了考核和经费分配方案,开始启用GeneXpert MTB/RIF快速检测技术,并推行互联网+DOT的远程视频督导和普通涂阳肺结核患者居家隔离措施;2018年参保人员肺结核(包括耐多药肺结核)专科门诊治疗开始享受医疗保险门诊大病待遇。2017—2018年活动性肺结核患者在定点医疗机构接受治疗的比率为82.43%(962/1167),肺结核确诊患者中病原学诊断率为54.93%(379/690),肺结核患者痰培养率为94.49%(652/690),肺结核可疑症状者和疑似患者查痰率为89.00%(2064/2319),辖区非结核病防治机构报告肺结核可疑者转诊到位率为58.19%(1893/3253);与2015—2016年[72.35%(772/1067)、44.69%(345/772)、53.89%(416/772)、86.67%(1814/2093)、52.17%(2199/4215)]相比均有明显提高,差异均有统计学意义(χ²值分别为32.61、15.28、305.17、5.63、26.88,P值分别为0.000、0.000、0.000、0.020、0.000)。2017—2018年细菌学检查阳性患者密切接触者肺结核筛查率为100.00%(1128/1128),肺结核患者治疗成功率为95.24%(480/504);2015—2016年细菌学检查阳性患者密切接触者肺结核筛查率为100.00%(1078/1078),肺结核患者治疗成功率为94.45%(698/739),均维持在较高水平,治疗成功率差异无统计学意义(χ²=0.37,P=0.540)。结论 福田区实施结核病分级诊疗和综合防治服务模式试点工作后,取得了良好的效果,可以继续推广并进一步优化。     

The cost of treatment in new case and multidrug resistant case in pulmonary tuberculosis

The treatment of multidrug-resistant pulmonary tuberculosis (MDR-Tbc) is quite difficult, and the disease has high morbidity and mortality rates. This study was designed to compare the costs of treatment in new tuberculosis (new-Tbc) cases and MDR-Tbc cases. Data base of the study was composed of the data from therapy principles of new-Tbc cases and MDR-Tbc, and official directives and price lists of Turkish Pharmacology Society in 2001 fiscal year regulating treatment costs. For new-Tbc cases, the treatment cost included expanses for 20 days of hospitalisation, one month work loss and six months drug supply and laboratory costs; for MDR-Tbc cases, it was comprised by expenses for seven months hospitalisation in average, 12 months work loss, 24 months drug supply and laboratory costs, and probable surgical interventions and post-operative intensive care. The service of hospital stuff and medical equipment provided was disregarded. The cost analyses was calculated as charge price of American dollars ($) dated 14.09.2001. It was found that the cost of therapy for new-Tbc cases and MDR-Tbc cases were 1134.89 $ and 17529.15 $, respectively. In MDR-Tbc cases, the costs of hospitalisation, work loss, drug therapy and laboratory procedures were 10.5, 12, 98.7 and 5.3 times higher respectively, when compared with those of new-Tbc. The cost of thoracotomy for one patient including the cost for 10 days period of post-operative care in intensive care unit was 391.93 $. The treatment of MDR-Tbc has a high cost, and 16 new-Tbc cases can be treated with the same cost in our country. In conclusion, we think that successful treatment strategies for both new-Tbc cases and MDR-Tbc cases will lower the cost of tuberculosis treatment.     

Prevention of tuberculosis in the migrant rural population and means of improving its effectiveness

Detection of pulmonary tuberculosis, its clinical process and certain peculiarities of its prophylaxis in rural migrants and particularly in persons leaving the region during season work were analyzed. It was shown that the incidence of tuberculosis among the migrants was higher than that among non-migrants of the control group. Often (11 per cent) they had severe acute specific lesions in the lungs usually not observed in persons not migrating. Unaccustomed climatic and geographical conditions, epidemiological situation with respect to tuberculosis in the new places, traces of cured intrathoracic primary tuberculosis, irregular fluorographic examinations and bad habits were the leading factors in development of the disease in the migrants. Recommendations for prophylaxis of respiratory tuberculosis in rural migrants are presented.