The Effects And Influence Factors Of DOTS Strategy

Tuberculosis has a long history; it is an infectious disease of international importance. About one-third of the world's population is infected with Mycobacterium tuberculosis. Every year, approximately eight million people infected active disease and two million die of TB. Tuberculosis is the primacy cause of death. It is the highest mortality infectious diseases of simplex cause. China is one of the higher disease burden countries of tuberculosis, the patients get the second highest ranks in the world, the number of the tuberculosis patients is occupied one fourth in the world, about 250 thousand patients died of tuberculosis every year. And that the decline of prevalence rate of tuberculosis in China is much slow, the decline trends from 1990 to 2000 is 27.6%, only 3.2% per year. Tuberculosis has become a serious public health problem. Control and eradicate tuberculosis has a far-reaching significance on protecting people's health and promoting the economic development. DOTS strategy is a global TB control strategy recommended by WHO. At present it is considered the strategy that has the lowest cost and better effect. But the carrying out of DOTS in every country is different, so each country should evaluate it according to the local institution. OBJECTIVES The general objectives of this study is to analyze the effects and the influences factors of DOTS strategy. The specific objectives include:Evaluate the effects of DOTS strategy of World Bank Loan Project of TB Control by analyzing the tuberculosis case registration rate and epidemic situation. From the five parts of the DOTS strategy evaluate the effect and problem of the TB control project in China. Analyze the influence factors of DOTS strategy, and provide policy implications for the TB control project. RESEARCH CONTENTS1. Describe and analyze the geographic distribution of the tuberculosis case registration rate in the 13 World Bank loan provinces.2. Analyze the trends of the tuberculosis case registration rate in Guangdong, Hubei and Sinkiang from 1992 to 2000. 3. Compare the prevalence of tuberculosis in east, middle and west areas in China.4. Analyze the trends of the prevalence of tuberculosis in the 13 World Bank loan provinces from 1990 to 2000.5. Analyze the influence factors on carrying out of DOTS strategy of the patients.6. Analyze the influence factors on the government commitment, drug supply and the supervision system. DATA COLLECTION1. Registration and report system. From National Center for Tuberculosis Control and Prevention China CDC, collected the tuberculosis case registration rate in the 13 World Bank Loan Provinces.2. National TB epidemiological random sampling survey. From National Center for Tuberculosis Control and Prevention China CDC, collected the compile of the data of the tuberculosis epidemiological random sampling survey. 3. Quantitative survey. From Wengniute County, Zhungeer County and Chayouhou county in Inner-Mongolia. Collected the basic information of the tuberculosis patients, the social behavior such as the patients' property, seeking the care, therapy, periodic back-check, awareness, health service access and the influence factors.4. Literature review. Look up the population of every provinces or cities at the end of 1999 from The Area Economic Yearbook of China 2000.5. Qualitative survey. From the sanitation Health Bureau and the Epidemic Prevention station in Hefeng County of Hubei Province, collected the data of government commitment, drug supply, and supervision system, and the influence factors; from the statistic bureau, collected the society-economic status data; from the county hospital of Hefeng county, collected the diagnoses,treatment, case referral and case report; From the basic medical establishment such as public health center of Zouma rural and Yanzi rural, the clinic of Xiangxi village of Hefeng County, collected their awareness to the project, the data of diagnoses and treatment on the patients, and the record of case referral sy...