| Objective: The objective was to investigate the current status of tuberculosis(TB)prevention and control service system in Kashi,Xinjiang,analyze the reported TB incidence,registered TB incidence,rate of smear positive TB patients,and assess the effectiveness evaluation of TB control service system,which will provide referable recommendations for improving the quality of TB control and prevention.Method: We used the literature review,field investigation and sampling survey to conduct this study.The health personnel,health facilities,health funds,medical services,medical security,reported TB incidence,registered TB incidence,rate of smear positive TB patients and completed rate of each index from the TB control service system in Kashi were compared between 2012 and 2016.In addition,three towns were randomly selected to perform the questionnaire survey,medical check,and quality control of laboratory works to assess the quality of TB diagnosis,workflow of TB patients seeking health care,and the adherence of TB patients,and the efficacy of new model in TB control.Result: Overall,the TB prevention and control service system in Kashi has been gradually established and improved,and the funding input was increased from 7.151 million in 2012 to 21.8143 million in 2016.In addition,multiple indexes were significantly increased in 2016 when compared with those in 2012,including the reported TB incidence from 239.5609/100,000 in 2012 to 305.7196/100,000 in 2016,detection rate of HIV from 1.48%in 2012 to 88.75%in 2016,and sputum examination rate of new TB cases from 63.90%in 2012 to 83.27%in 2015.The screening rate of drug-resistant TB in 2016 was 94.48%.New model of TB prevention and control service system was established in Yuepuhu,and Shufu county,respectively,in which the suitable policies on TB control were implemented.Of note,the completion rate of active TB patients reached 100%;the total arrival rate and screening rate of multidrug resistant suspects were more than 90%;and qualification rate of chest X-ray was 99%.Despite these progress,we acknowledged the shortage of professional staffs,and most of the staffs had low educational background and low title.The decline trend was observed in several indexes,including the rate of smear positive TB patients from 26.79%in 2012 to in 2016,the cure rate of new TB cases from 95.40%in 2012 to 82.08%in 2016,and the cure rate of retreated TB cases from 85.90%in 2012 to 54.65%in 2016.The low positive rates of were observed in both new cases and follow-ups in Kashi District,associated with the low percentage of qualitied sputum samples.Conclusion: The new model of TB prevention and control service system has been generally established in Kashi District.The detection rate of pulmonary TB case has significantly increased.In addition,multiple indexes in 2016 have improved when compared with these in 2012,including the report,treatment and management of TB patients,attributed to the application of new model of TB control.However,several indexes have been decreased in the past years,which should been paid more attention in the future.screening rate reached 90%in the chest,a pass rate of more than 99%. |
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