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目的:评价巴塞罗那结核病控制规程的效果和提出评价指标。材料和方法:应用定量指标评价1987至1999年规程的结果和作用,按指标内容进行统计分析,包括结素试验反应趋势和发病率的变化。结果:结核病发病率1987至1991年上升(P=0.10),1991至1999年之间下降(P<0.001)。在研究期间由医生报告的病例百分比,坚持治疗和直接观察下治疗(DOT)的病例百分比和0-4岁组儿童中脑膜炎有明显下降,均具有统计学意义。然而,在涂阳病例诊断延迟和检查接触者的病例百分比没有显著改变。评价显示结核病发病率平均年递降率为6.7％。坚持治疗率达到目标(在涂阳病例中为94.5％)。平均诊断延迟中位数(36天)和接触者检查的病例百分比(平均59.8％)仍不乐观。结论:评价结果总体上是好的。认为发病率下降、儿童脑膜炎、治疗坚持率、诊断延迟和检查接触者的病例百分比是结核病规程较好的评价指标。
PURPOSE: To evaluate the effectiveness of the Barcelona TB Control Protocol and to propose evaluation indicators. MATERIALS AND METHODS: The quantitative and qualitative indicators were used to evaluate the results and effects of the protocol from 1987 to 1999. Statistical analyzes were performed according to the indicators, including the trend of response to tuberization test and the change of morbidity. Results: The incidence of tuberculosis increased from 1987 to 1991 (P = 0.10), declining between 1991 and 1999 (P <0.001). The percentage of cases reported by physicians during the study period, the percentage of cases insisting on treatment and direct observation of treatment (DOT), and meningitis in children aged 0-4 years were significantly decreased, both of which were statistically significant. However, there was no significant change in the percentage of cases diagnosed as delayed and checking for contacts in smear-positive cases. The evaluation showed that the average annual decline rate of tuberculosis incidence was 6.7%. Adhere to the treatment rate reached the target (in smear positive cases 94.5%). The mean median diagnostic delay (36 days) and the percent of contacts examined (mean, 59.8%) are still not optimistic. Conclusion: The evaluation results are generally good. The percentage of cases considered to have decreased morbidity, childhood meningitis, treatment adherence rates, delayed diagnosis, and contact examinations is a better indicator of tuberculosis procedures.