Ingle R F, Irwig L M
Department of National Health and Population Development, East London, CP.
S Afr Med J. 1991 Feb 2;79(3):127-33.
In order to study the management of pulmonary tuberculosis among black and coloured adults in the Border region of South Africa in 1983, a historical inception cohort representative of tuberculosis hospitals and local authority health services was followed up over 15 months to assess how efficiently the national responsibility is discharged in a region. About 75% of patients were sputum-positive, and 81% were judged to have had active pulmonary tuberculosis. The mean service delay after radiography was about 1 1/2 weeks. About 26% of patients were treated with a rifampicin regimen, 50% were frequent attenders and 41% completed treatment, although about 21% were still being treated after 15 months. There was a deficiency of laboratory information for diagnosis and monitoring of response to treatment. Periodic cohort evaluation and improvement of diagnostic efficiency, of peripheral use of laboratories, and of spending on community service infrastructure are essential for closing the gap between policies and implementation.
为研究1983年南非边境地区黑人和有色人种成年肺结核患者的管理情况，选取了一个具有代表性的历史起始队列，涵盖结核病医院和地方当局卫生服务机构，对其进行了15个月的随访，以评估该地区履行国家职责的效率。约75%的患者痰涂片阳性，81%被判定患有活动性肺结核。X线检查后的平均服务延迟约为1.5周。约26%的患者接受了利福平方案治疗，50%为频繁就诊者，41%完成了治疗，尽管15个月后仍有约21%的患者在接受治疗。在诊断和监测治疗反应方面缺乏实验室信息。定期进行队列评估，提高诊断效率、实验室的外周利用率以及社区服务基础设施的投入，对于缩小政策与实施之间的差距至关重要。
