实施结核病防控“新疆模式”的效果及影响因素：一项定量研究

Effectiveness and Determinants of Implementing the "Xinjiang Model" for Tuberculosis Prevention and Control: A Quantitative Study.

作者信息

Zhang Yan, Wang Senlu, Wang Xinqi, Liu Nianqiang, Wang Le, Wang Xiaomin, Liang Zhichao, Wang Junan, Aili Abulikemu, Cao Mingqin

机构信息

Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, 830011, People's Republic of China.

The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830002, People's Republic of China.

出版信息

Infect Drug Resist. 2024 Jun 24;17:2609-2620. doi: 10.2147/IDR.S459228. eCollection 2024.

DOI:10.2147/IDR.S459228

PMID:38947373

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11213531/

Abstract

OBJECTIVE

To analyze the effectiveness of the "Xinjiang Model" for tuberculosis prevention and control in Kashgar Prefecture, Xinjiang, and to explore the determinants of the policy implementation effect.

METHODS

The registration data of pulmonary tuberculosis (PTB) patients in Kashgar Prefecture from 2012 to 2021 were collected to describe the temporal trend of registered incidence. A questionnaire survey was conducted among PTB patients registered and treated in the tuberculosis management information system in Zepu and Shache Counties from January 2022 to July 2023 to collect and analyze "Xinjiang model" determinants of effectiveness.

RESULTS

The PTB registered incidence in Kashgar Prefecture showed a significant increasing trend from 2012 to 2018 (APC=18.7%) and a significant decreasing trend from 2018-2021 (APC=-28.8%). Among the Kashgar Prefecture, compared with average registered incidence in 2012-2017, registered incidence in 2021 in Shufu, Maigaiti, and Zepu Counties had a greater decline rate of 58.68%, 57.16%, and 54.02%, respectively, while the registered incidence in 2021 in Shache County increased by 6.32%. According to the comprehensive analysis of the factors affecting the effect of policy implementation, the proportion of PTB patients in Zepu County whose health status has now significantly improved compared with that before treatment was significantly greater than that in Shache County (<0.05); patients in Shache County were significantly less aware than those in Zepu County of how to take tuberculosis drugs, precautions, adverse reactions, and regular reviews during treatment; the factors that accounted for the greater proportion of heavy treatment burden in both Shache and Zepu Counties were discomfort caused by taking or injecting drugs, accounting for 12.8% and 8.7%, respectively.

CONCLUSION

The "Xinjiang model" can effectively control the epidemic situation of tuberculosis in Kashgar, and the knowledge of tuberculosis treatment, adverse reactions to tuberculosis drugs, and treatment costs were the determinants of the effectiveness of policy implementation.

摘要

目的

分析“新疆模式”在新疆喀什地区结核病防控中的效果，并探讨政策实施效果的影响因素。

方法

收集喀什地区2012年至2021年肺结核（PTB）患者登记数据，描述登记发病率的时间趋势。2022年1月至2023年7月，对泽普县和莎车县结核病管理信息系统中登记治疗的PTB患者进行问卷调查，收集并分析“新疆模式”效果的影响因素。

结果

喀什地区PTB登记发病率在2012年至2018年呈显著上升趋势（年度百分比变化率[APC]=18.7%），在2018年至2021年呈显著下降趋势（APC=-28.8%）。在喀什地区，与2012年至2017年的平均登记发病率相比，疏附县、麦盖提县和泽普县2021年的登记发病率下降幅度更大，分别为58.68%、57.16%和54.02%，而莎车县2021年的登记发病率上升了6.32%。综合分析影响政策实施效果的因素，泽普县PTB患者健康状况较治疗前显著改善的比例显著高于莎车县（<0.05）；莎车县患者对治疗期间如何服用抗结核药物、注意事项、不良反应及定期复查的知晓程度显著低于泽普县患者；莎车县和泽普县治疗负担较重的因素中，服药或打针引起的不适占比分别为12.8%和8.7%，占比较大。