Evaluation On The Implementation Of A New Tuberculosis Prevention And Control System In Xinjiang

Objective: By studying the implementation model and working method of the new tuberculosis(TB)prevention and treatment service system in Xinjiang,analyzes were made to compare the advantage and disadvantages between the new control service system and the traditional model;to evaluate the implementation results in order to improve the quality of Xinjiang TB prevention and control service and provide constructive recommendations.Methods: Using empirical study and policy analysis,qualitative and quantitative research were carried out to evaluate the implementation model of the new TB prevention and treatment service system in Xinjiang.Interviews were conducted with management officials and staffs of the TB prevention and control institutions to collect the working reports of the Xinjiang TB control program for 2011-2015 to evaluate the effectiveness of the new model.Results: After the complete implementation of new TB control service system in Xinjiang in 2015,parts of the TB prevention and control work index were significantly higher than the traditional model in 2011.The detected TB cases using the traditional model in 2011 increased from 34,432 cases per year to 42,413 cases per year using the new model in 2015;the newly diagnosed pulmonary tuberculosis suspicious sputum rate increased from 49.13% in 2011 to 72.92% in 2015;the rate of tuberculosis patient registration management increased from 66.69% in 2011 to 76.81% in 2015;the referral rate of tuberculosis patients increased from 78.04% in 2011 to 82.61% in 2015;tuberculosis patient effective referral rate increased from 28.65% in 2011 to 2015 59.61%;the tracking arrival rate increased from 67.89% in 2011 to 83.64% in 2015;the overall effective rate increased from 79.19% in 2011 to 2015 94.66%.However,some indicators have decreased such as new smear positive task completion rate declined from 100% in 2011 to 2015 75.54 %,the new smear-positive case detection rate declined from 70 % in 2011 to 52.87% in 2015.Conclusion: The new TB prevention and treatment service system has been established in Xinjiang,and the cooperation between diseases prevention and control institutions,medical institutions and primary health care institutions has been continuously improved.Detection and diagnostic level of TB cases has been continuously improved.Treatment behavior of TB patients has been further regulated.Reporting,referrals,tracking of TB patients and other related index increased sharply.The medical and health resources have been fully used and prevention work made significant progress.However after the implementation of the new model,the new smear-completion rate and the new smear-positive rate showed a significant decline.Careful analysis needs to be conducted so that both rates could be improved in future work.