中文摘要
流动人口是耐多药结核病(MDR-TB)的易感人群和桥梁人群,大量流动人口的流入给流入地MDR-TB疫情带来巨大影响,也影响MDR-TB的防控策略的效果。目前尚缺乏评估流动人口对MDR-TB的影响大小的研究,MDR-TB的防控策略也未考虑当地流动人口规模和比例的影响。本研究拟建立流动人口MDR-TB传播动力学模型,模拟不同流动人口规模和比例条件下,MDR-TB疫情的变化趋势。比较在流动人口、本地人口和全人口实施对潜在TB患者进行筛查、对纳入治疗的TB患者分别进行医疗补偿、药物敏感性测试(DST)全覆盖、引进先进DST检测技术、对纳入治疗的MDR-TB患者进行医疗补偿五种干预策略的成本效果、成本效益和成本效用,确定MDR-TB防控的重点人群。模拟不同流动人口规模和比例条件下最优的成本-效果、成本效益和成本效用,提出优化的干预策略,为不同地区的MDR-TB防控策略的制定提供参考依据,具有示范作用
英文摘要
Migrants are vulnerable population of multi-drug resistant tuberculosis (MDR-TB). They also bridge the transmission of MDR-TB. Numerous studies have demonstrated the increasing migration scales greatly impact the epidemics of MDR-TB. The effectiveness of preventive strategies of MDR-TB varied from regions to regions due to diversified number of migrants. However, current studies lack to evaluate the impact of number of migrants on the MDR-TB epidemics. Strategies on MDR-TB prevention rarely considered the influence of number of migrants. This study aim to establish an evaluation and projection model for migrants on MDR-TB (EPM M-MDRTB). We model the trends of MDR-TB epidemics changing with the immigration trends. Preventive strategies including screening on latent TB patients, reimbursement for the TB patients, 100% coverage of drug susceptible test (DST) for MDR-TB, introduce advanced DST techniques, and reimbursement for the MDR-TB patients are compared of the effectiveness, cost-effectiveness, cost-benefit, and cost-utility in the scenarios of varied number of migrants, to identify key target population and the priority strategies. The methodology provide clue for other regions and countries with different migrants scales.
