落实预防为主,强化综合干预,为终结结核病流行提供加速度——中牟科研项目现场实施成效的启示  

Prioritizing prevention and enhancing comprehensive interventions to accelerate the end of tuberculosis epidemic-Insights from the implementation of the research projects in Zhongmu County

作　　者：辛赫男 王大宽 张彬 刘自森 段伟焘 高磊 Xin Henan;Wang Dakuan;Zhang Bin;Liu Zisen;Duan Weitao;Gao Lei(National Institute of Pathogen Biology,Chinese Academy of Medical Sciences,Beijing 102629,China;Zhongmu County Center for Disease Control and Prevention,Zhengzhou 451450,China)

机构地区：[1]中国医学科学院病原生物学研究所,北京102629 [2]河南省郑州市中牟县疾病预防控制中心,郑州451450

出　　处：《中国防痨杂志》2024年第12期1429-1433,共5页Chinese Journal of Antituberculosis

基　　金：中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-037)。

摘　　要：尽管我国结核病防控工作取得了显著成效,但距离2035年“终结结核病流行”的全球战略目标还有很大差距。防控策略从“防治结合”向“预防为主”的倾斜成为我国实现结核病发病率快速下降的必然需求。随着《无结核社区行动方案》的发布和实施,重点人群结核病主动发现工作已成为各地结核病防控的重点工作,能否以此为契机同时在重点人群中推广结核病预防性治疗值得探索。笔者团队在河南省郑州市中牟县针对农村社区重点人群开展了多项结核分枝杆菌潜伏感染流行病学调查和干预研究项目,经过十年的工作积累,中牟县结核病报告发病率由2013年的85/10万逐步下降至2023年的19/10万,下降速度快于郑州市平均水平。科研项目实施过程中逐步形成的重点人群“患者主动发现+潜伏感染者预防性治疗”的“中牟模式”为建立新型结核病综合干预防控策略提供了借鉴。今后,经过更加系统和深入的研究、实践及优化,重点人群综合干预新策略的形成或将为“终结结核病流行”提供加速度。Although significant achievements had been achieved in tuberculosis(TB)control in China,the global targets of the“End TB”by 2035 is still far from reach.The focus of TB control strategies shifting from“integration of prevention and treatment”to“prevention-oriented control”will be necessity in China.With the release and implementation of the Action Plan for Tuberculosis-Free Communities,active case finding(ACF)among key populations has become an important part of TB control work.It is worth exploring whether tuberculosis preventive treatment(TPT)could be integrated with ACF among these key populations.Our team conducted latent tuberculosis infection(LTBI)epidemiological surveys and intervention studies among key populations in rural communities in Zhongmu County,Zhengzhou City,Henan Province.After ten years of work,the notified TB incidence rate in Zhongmu County dropped from 85/100000 in 2013 to 19/100000 in 2023,the declining is faster than the average level in Zhengzhou City.The gradually formed“Zhongmu Model”during the implementation of research projects,featuring“ACT+TPT”in key populations,provides reference for establishing a new community-based intervention strategy.In the future,through more systematic and in-depth research,practice and optimization,the formation of integrated intervention strategy targeting key populations will accelerate the achievements of the“End TB”goals.

关 键 词：结核 人群监测 主动发现 抗生素预防 总结性报告 

分 类 号：R52[医药卫生—内科学]