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目的分析自2006年10月—2014年6月,深圳市实施全球基金耐多药结核病防治项目的效果,以期为调整全市的耐多药结核病综合防控策略提供依据。方法从结核病信息管理系统及2006年10月—2014年6月深圳市全球基金耐多药结核病防治项目工作月报、季报和年度报表收集相关信息,分析全市耐多药结核病政策保障情况、体系建设情况、项目覆盖情况、病人发现情况、治疗情况等。结果在项目实施期间,成立了领导小组和技术指导小组,建立了工作机制、医疗保障和法律保障。建立MDR-TB三级防控网络、市区两级诊断平台、市区两级实验室网络。项目覆盖全市所有10个区和全市所有人群,包括户籍人口和流动人口。将MDR-TB的筛查对象扩大到所有涂阳肺结核患者,包括新涂阳和复治涂阳患者。项目实施期间,全市共发现MDR-TB患者607例,纳入项目治疗168例,成功治疗率高达70.2%。结论通过项目的实施,发现“传播”已成为全市耐多药结核病产生的主要原因,加上对流动人口耐多药结核病缺乏有效的控制手段,耐多药结核病疫情面临的形势十分严峻,迫切需要有效措施,以防止耐药结核病疫情进一步蔓延。
Objective To analyze the effect of implementing the Global Fund for Drug Control and Prevention (MDR-TB) project in Shenzhen from October 2006 to June 2014 with a view to providing evidence for the adjustment of the comprehensive prevention and control strategy for MDR-TB in the city. Methods From the information management system of tuberculosis and the monthly, quarterly and annual reports of the Shenzhen Global Fund MDR-TB Prevention and Control Project from October 2006 to June 2014, the related information was collected to analyze the protection of MDR-TB policy in the city and the system construction Situation, project coverage, patient discovery, treatment and so on. Results During the implementation of the project, a leading group and a technical steering group were set up to establish a working mechanism, medical insurance and legal guarantee. The establishment of MDR-TB three prevention and control network, two-level urban diagnostic platform, urban two-level laboratory network. The project covers all 10 districts in the city and all the people in the city, including household registration population and floating population. Screening patients for MDR-TB for all smear-positive TB patients, including new smear-positive and retreatment smear-positive patients. During the implementation of the project, a total of 607 MDR-TB patients were found in the city, 168 were included in the project, and the successful treatment rate was as high as 70.2%. Conclusion Through the implementation of the project, we found that “transmission ” has become the main cause of MDR-TB in the whole city. Coupled with the lack of effective control measures for MDR-TB in floating population, the situation of MDR-TB epidemic is very grim, There is an urgent need for effective measures to prevent the spread of a drug-resistant tuberculosis epidemic.