| Background:Tuberculosis is second fatal infectious disease besides HIV/AIDS. China is one of the world’s22TB high-burden countries, with its new cases each year ranking in second place in the world. There are several special characteristics with Tuberculosis epidemic in our country:the large infected population, a large number of patients (especially rural), new cases, death, and patients with drug resistance. At present, the main characteristics of pulmonary tuberculosis in Shanghai is the increasing number of the migrants, increasing number of pensioners and resistant/complications in patients. Tuberculosis has the second incidence in infectious diseases in Shanghai. There is no comprehensive analysis or research related to TB in Huangpu District presently, because of low number of TB cases in this area.Objective:After analyzing present status of tuberculosis prevention and control in Huangpu district of Shanghai from2006to2010, this study aims to understand the epidemic trend, epidemic situation and the distribution characteristics. Secondly, through analysis of the2006-2010tuberculosis epidemics in registered and migrant population in Huangpu district, to understand the problems of different groups in the TB prevention and control work. Thirdly, through surveys and interviews of tuberculosis prevention and control measures, human resources, relevant staff awareness in Huangpu district, to understand the implementing situation and problems. Finally, to provide suggestions to improve the tuberculosis control strategy of Huangpu district.Subject and Method:the objects of study in quantitative part includes new TB cases in registered population and migrants in the Huangpu district from2006to2010, and random sampling survey about knowledge of190medical personnel in19medical institutions. In qualitative part, we interviewed five tuberculosis prevention and control staffs and6tuberculosis patients. Materials were classified mainly according to the research problem. Also, using literature and policy documents review of the Shanghai Huangpu district control network, human resources, policy support, and basic situation, and problems of tuberculosis prevention and control work in this area.Results:From2006to2010, the registration rate of active pulmonary tuberculosis cases, the new registration rate of smear-positive cases and the percentage of smear-positive cases declined from32.17/100000,12.87/100000,40.00%to29.53/100000,10.14/100000,34.33%, and the cure rate of smear-positive patients increased from75.00%to82.46%. From2006to2010, the statistics of the migrants is higher than the registered population in respect of registration rate of active pulmonary tuberculosis cases, new registration rate of smear-positive cases on average, and is remarkably higher than the average emigration rate. Meanwhile, difficulties and problems caused by unknown condition of patients, lack of human resource, insufficient management capacity, inadequate knowledge about TB and migrants swarming into the city still exist.Conclusion:From2006to2010, pulmonary tuberculosis control and prevention in Huangpu district of Shanghai are generally in good condition. Generally speaking, the pulmonary tuberculosis prevention and control of migrants in Huangpu district of Shanghai are in a stable situation, but still not so optimistic. Although the awareness rate of medical personnel about pulmonary tuberculosis in Huangpu District is higher than the average level of Shanghai City, there is a large gap regarding the "National TB control program (2001-2010years)" requirements of the national tuberculosis prevention knowledge awareness rate (80%). In the next stage, regional pulmonary tuberculosis prevention and control plans should be worked out; the number of relevant staff for pulmonary tuberculosis control should be increased; organization structure should be improved; staff training should be strengthened and staff stabilization should be maintained. Besides, the link and supervisory managements should be reinforced by improving system of rewards and penalties, and administrative management, such as treatment-prevention cooperation, should be promoted. Moreover, more efforts should be put into information construction and research of new management way of pulmonary tuberculosis control and prevention. Finally, awareness of population at all levels on pulmonary tuberculosis control and prevention and relevant policies should be raised by spreading the knowledge more widely. And measures on pulmonary tuberculosis control and prevention of migrants should be further studied. |
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