Ruohonen R P, Goloubeva T M, Trnka L, Fomin M M, Zhemkova G A, Sinitsyn A V, Lichachev A A, Koskela K G
Finnish Lung Health Association, Helsinki.
Int J Tuberc Lung Dis. 2002 Mar;6(3):192-7.
The DOTS pilot project for tuberculosis control in the Leningrad Region of the Russian Federation, supported by the Finnish Lung Health Association and the World Health Organization (WHO).
To assess the efficacy of WHO-recommended standard short-course chemotherapy in newly detected pulmonary tuberculosis cases positive by smear or with extensive lung lesions suggestive of culture positivity, under project conditions.
Analysis of data on case detection, sputum smear conversion and treatment outcome based on standardised (WHO) registers from districts and a central computerised database.
Of 859 adult pulmonary tuberculosis cases (292 smear-positive) notified in the Leningrad Region in the study period, 312 new cases were included in the project. The sputum conversion rate at the end of the second month was 82.8% and 91.1% at the end of the third month. Of bacteriologically confirmed cases, 71.3% were successfully treated, 4.9% died, 11.7% defaulted and 8.1% failed.
In the first year of the pilot project in the Leningrad Region, the DOTS strategy revealed feasibility and moderate efficacy among new pulmonary tuberculosis cases who were either smear-positive or showed extensive lung lesions on chest X-ray, and who were therefore of high epidemiological and medical priority.
由芬兰肺部健康协会和世界卫生组织（WHO）支持的俄罗斯联邦列宁格勒地区结核病控制直接督导下的短程化疗（DOTS）试点项目。
在项目条件下，评估WHO推荐的标准短程化疗对新发现的涂片阳性或有提示培养阳性的广泛肺部病变的肺结核病例的疗效。
基于各地区标准化（WHO）登记册和中央计算机数据库，分析病例发现、痰涂片转阴及治疗结果的数据。
在研究期间列宁格勒地区通报的859例成人肺结核病例（292例涂片阳性）中，312例新病例纳入该项目。第二个月末痰转阴率为82.8%，第三个月末为91.1%。在细菌学确诊病例中，71.3%成功治愈，4.9%死亡，11.7%失访，8.1%治疗失败。
在列宁格勒地区试点项目的第一年，DOTS策略在涂片阳性或胸部X线显示有广泛肺部病变的新肺结核病例中显示出可行性和一定疗效，因此这些病例具有较高的流行病学和医学优先级。
