| Research backgroundTuberculosis is a serious infectious disease which is harmful to the society and the health of people. It is one of the major infectious diseases that our government enlarges the intensity and control. It is a chronic infectious disease caused by mycobacterium tuberculosis. It can affect the whole body and multiple organs, the most common is pulmonary infection, that is tuberculosis. Since the mid 80’s in twentieth Century, the global tuberculosis epidemic situation has a sharp upward trend According to the World Health Organization estimates, currently there are two billion people infected with mycobacterium tuberculosis, and the speed of the new 8 million to 10 million cases is increasing every year. China is one of the 22 countries with high burden of tuberculosis. At present, the number of tuberculosis patients in China is the second in the world. The situation of tuberculosis epidemic in Jinan City is also very grim. The incidence of tuberculosis has been ranked in the first two of the infectious diseases of statutory reporting. It has seriously affected the health of the people and the development of the economy. Jinan has introduced and implemented a modern tuberculosis control strategy (DOTS strategy) since 1992. The management for the smear positive tuberculosis patients is the free-short-course chemotherapy and the whole-course supervision. After the implementation of the DOTS strategy, the level of pulmonary tuberculosis patients discovery and treatment is greatly improved in Jinan. The recurrence of tuberculosis has decreased. It effectively prevents the generation of drug resistant cases. The concept of tuberculosis control in the relevant institution has been change, The tuberculosis control work in Ji’nan entered the stage of the standardization management.Research objectiveTo study the epidemiological characteristics of tuberculosis during 2009-2013 in Jinan city, investigate therapy outcomes of tuberculosis patients, analyze related factors and provide technical basis for sustainable development of TB control.Materials and methodsAll patients with active tuberculosis during 2009-2013 in Jinan city were obtained from National TB management information system. All patients got free anti-tuberculosis drug treatment recommended by national standard chemotherapy and DOTS model were used tin the management of patients. Enter the treatment and management information of patients with TB into management information system. The information and data of Jinan City in social, geographic and demographic are come from yearbook of Jinan Municipal Bureau of Statistics. The data of patients with active tuberculosis comes from Tuberculosis information management system.provided by the Jinan Center for Disease Control and Prevention.Main results(1) There are 9618 cases of tuberculosis patients in Ji’nan city during 2009-2013. Among the patients, the referral patients and the patients who were followed were the highest. It accounts for 72% of the total number of patients.(2) The discovery way of finding the tuberculosis patients in Jinan city is based on the passive discovery. The number of patients diagnosed by active screening is less than 1%.(3)The diagnosis, treatment and management of tuberculosis need to rely on the referral of medical institutions and on the tracking management of tuberculosis prevention agency. This is the combination of the two,new mode of medical cooperation.(4) Jinan City, the registration rate of tuberculosis between 29.24-32.57/ 100,000 volatility, changed slightly lower than the average level in Shandong Province. Registration rate of new smear positive TB cases fell from 2010’s 18.95/ 100,000 in 2013 to 7.76/100,000, the rate of decline was faster than the rate of decline overall registration rate of tuberculosis patients.(5)Five years, registered 4365 cases of smear-positive TB patients registered 5173 cases of smear negative pulmonary tuberculosis patients, smear-positive and smear-negative patients than become normal.(6) Jinan City TB epidemic case reports throughout the year, including the second and fourth quarter, relatively high incidence, respectively, accounted for 27.5% and 26.4% for five years the total incidence, suggesting that spring, winter Jinan City, presenting a higher incidence of tuberculosis level.(7) Jinan City tuberculosis patient registration report, the number of patients was significantly higher than in rural towns. Mostly male patients, male patients in each age group were higher than female patients. Female patients 15 to 24 age group has a peak incidence, while male patients 15 to 24 age group and the 55 to 65 age group two incidence peaks.(8)TB high-risk occupation were farmers, housekeeping, housework and unemployed, students, workers and retirees.(9) Jinan Xinfa management rate of smear-positive patients, the cure rate reached 90%. The cure rate of new smear-positive patients were significantly higher than retreatment smear positive patients. Smear-negative patients complete treatment is higher than the cure rate of new smear-positive patients.Conclusion and suggestionJinan City of tuberculosis prevention and control work has shown good overall trend, but prevention and control situation is not optimistic. The next step to strengthen health education, adhere to national health education with a combination of population health education to increase public awareness and correct behavior formation rate; establish comprehensive medical institutions found that patients with TB control agencies, institutions and tuberculosis TB hospital, TB way referral hospitals, primary health care institutions to undertake TB prevention and control system, a number of prevention work; improve TB control agencies, strengthen personnel training, to enhance the professional and technical capacity; guarantee funding to protect patients found that treatment management, surveillance, training, supervision, publicity implementation of education, research and other control measures; school attaches great importance to the prevention and control of tuberculosis, to prevent outbreaks of tuberculosis in schools; perfect proactively identify strategies to carry out targeted close contacts of TB, screening for HFV-infected persons and other key populations, early detection of tuberculosis patients; various medical institutions at all levels to effectively implement the tuberculosis patients or suspected patients reporting and referral system. |
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