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目的定性调查基层结核杆菌/艾滋病病毒(TB/HIV)双重感染诊断治疗专家组合作机制及其影响因素,为制定国家TB/HIV双重感染合作机制提供科学依据。方法选择已经开展TB/HIV双重感染的3县(区),使用观察法和关键知情人深入访谈的方法,了解TB/HIV双重感染防治合作现状和影响因素。结果成立TB/HIV双重感染诊断治疗专家组是十分必要的,且需要建立由结核病专家和艾滋病专家组成的诊断治疗专家组;三县为开展TB/HIV双重感染工作,初步建立了疾病预防控制机构或传染病专科医院为中心的会诊模式;会诊中以HIV/AIDS中结核病的诊断和治疗方案为主。但是领导重视程度和协调机制、专家诊断治疗水平、医疗机构参与、医生态度和投入的时间等因素仍然是导致诊疗延误的重要因素。结论建立结核病/艾滋病双重感染诊断治疗专家组,是结核病/艾滋病防治合作机制的重要内容。通过加强领导重视和制度建设;加强疾病预防控制机构和医疗机构间的协调力度;医患双方的宣传教育健全合作机制,避免和减少延迟诊治。
Objective To qualitatively investigate the cooperation mechanism and influencing factors of TB TB / HIV dual infection diagnosis and treatment group and provide scientific evidence for establishing a national TB / HIV dual infection cooperation mechanism. Methods Three counties (districts) that had been infected with TB / HIV were selected. The methods of observation and key informant interviews were used to understand the current status and influencing factors of TB / HIV co-infection prevention and control. Results The establishment of TB / HIV dual infection diagnosis and treatment group is very necessary, and the need to establish a diagnosis and treatment of TB expert and HIV expert group; three counties to carry out TB / HIV dual infection, the initial establishment of a disease prevention and control agency Or infectious disease hospital as the center of the consultation mode; diagnosis and treatment of tuberculosis in HIV / AIDS-based programs. However, factors such as leadership emphasis and coordination mechanism, expert diagnosis and treatment level, participation of medical institutions, doctor’s attitude and time spent on inputting are still the important factors that cause delays in diagnosis and treatment. Conclusion The establishment of a panel of experts on the diagnosis and treatment of tuberculosis / AIDS with dual infection is an important part of the TB / AIDS cooperation mechanism. By strengthening the leadership and system construction, strengthening coordination between disease prevention and control agencies and medical institutions, and publicity and education among doctors and patients to improve the cooperation mechanism so as to avoid and reduce delayed diagnosis and treatment.