Evaluation Of The Efficacy Of Implementation Of An Active Screening Strategy For Pulmonary Tuberculosis In The South Xinjiang Area

Objective: To evaluate the effect of the implementation of pulmonary TB active screening strategies on the prevention and control of this tuberculosis epidemic in Xinjiang,and to evaluate its prevention and control efficacy,so as to provide a reference for promoting the implementation and optimization of pulmonary TB control measures in Xinjiang.Methods: First,we conducted a descriptive analysis of the registered incidence of pulmonary tuberculosis patients in the four districts of Southern Xinjiang and the whole Xinjiang during 2012-2021;To evaluate the effect of developing an active screening measure for pulmonary tuberculosis patients in 2018 in the four districts of Southern Xinjiang using interrupted time series with comparison before and after themselves;At the same time,a double difference method with the four districts of Southern Xinjiang as the treatment group and the other Prefecture as the control group was used to evaluate the policy effect of developing active screening measures for pulmonary tuberculosis patients in 2018;Factors associated with the registered incidence of pulmonary tuberculosis in the prefecture and district counties of Xinjiang were included as control variables,and then a virtual control group was generated by using the synthetic control method to estimate the net effect of the intervention by comparing the difference between the treatment group and the virtual control group after the policy intervention to assess the policy effect of active screening measures for pulmonary tuberculosis patients at the state level and county level in the District of Xinjiang in 2018.Results: The temporal trend of the registered incidence rate of pulmonary tuberculosis in the southern four regions of Xinjiang is consistent with that in the whole Xinjiang,all of which reached the vertex in 2018,and the contribution rate of active detection of pulmonary tuberculosis in the southern four regions of Xinjiang reached the first vertex(47.18%)in 2018 and the second vertex(58.71%)in 2020,then shifted to a decreasing trend;Interrupted time series assessment of tuberculosis active screening policy treatment effect,post intervention trend compared to pre intervention trend change effect was 212.03/100000;In the double differential method to evaluate the treatment effect of a pulmonary tuberculosis active screening policy,the average increase of registered incidence of pulmonary tuberculosis in four districts of South Xinjiang after the implementation of the policy intervention was 192.27/100000;When addressing the treatment effect of a policy of active screening for pulmonary tuberculosis in the four districts of Southern Xinjiang using a synthetic control method,the Aksu,heta,KASH,and Keju regions all showed an increase in the registered incidence of pulmonary tuberculosis,with the greatest change in the policy effect in 2018 at 281.99/100000,306.67/100000,697.39/100000,and 289.20/100000,respectively.The average increase in the registered incidence of pulmonary tuberculosis in the four years after the policy intervention was 188.57/100000,179.17/100000,respectively 32.93/100000,123.74/100000,and passed the robustness test;When the policy treatment effect of active screening for pulmonary tuberculosis was evaluated by synthetic control method in four treatment group counties(Aksu,heta,KASH,and Atush),the incidence of pulmonary tuberculosis registration increased,and the policy effect in 2019 was the largest at250.77/100000,250.36/100000,193.96/100000,and 84.26/100000,respectively.The average improved pulmonary tuberculosis registration incidence at 4 years after the policy intervention was 165.55/100000,78.73/100000,respectively 133.39/100000,2.69/100000,respectively,and passed the robustness test.Conclusion: Tuberculosis active screening strategy measures have a positive effect on the prevention and control of tuberculosis outbreaks in southern Xinjiang,which greatly increases the detection ability of tuberculosis patients,reduces the overall transmission risk of tuberculosis,and is beneficial for tuberculosis outbreak control.