Abstract: Objective To analyze the situation of tuberculosis screening among key groups in Haizhu District of Guangzhou City between 2016 and 2020 "The 13th Five-Year Plan for Tuberculosis Control", evaluate the effectiveness of tuberculosis prevention and control, and provide scientific basis for formulating tuberculosis prevention and control strategies. Methods By means of retrospective study, sociological and economic evaluation, the screening of family members of patients with etiologically positive tuberculosis, patients above 65 years old, diabetic patients, and close contacts of tuberculosis in schools in Haizhu District of Guangzhou City from January 2016 to December 2020 were analyzed. The count data were compared by χ 2 test. Results (1)A total of 2 911 cases of pulmonary tuberculosis were registered, 8 714 cases of close family contacts were screened, with a screening rate of 99.86%, and the positive rate was 0.24% (21/8 714). The positive rate of pulmonary tuberculosis in subjects with clinical symptoms was higher than that in subjects without clinical symptoms. (2)A total of 8 606 subjects above 65 years old were screened for suspicious symptoms of pulmonary tuberculosis, with a screening rate of 1.26% (8 606/682 011). A total of 10 472 diabetic patients were screened for suspicious pulmonary tuberculosis symptoms, 4 964 cases were screened by chest radiograph, 211 cases of pulmonary tuberculosis were screened out by symptom screening and chest radiograph, with a positive rate of 1.11% (211/19 078). (3)A total of 3 741 cases of pulmonary tuberculosis were screened for human immunodeficiency virus (HIV), 11 cases of them were positive for HIV, with a positive rate of 0.29% (11/3 741). A total of 6 697 HIV infected patients were screened for pulmonary tuberculosis, with a positive rate of 0.82% (55/6 697). (4)A total of 445 cases of pulmonary tuberculosis were enrolled in schools, 14 304 cases of close contact were screened, with a screening rate of 92.53%, 13 cases of pulmonary tuberculosis were screened out, all of them were students, with a positive rate of 0.09% (13/14 304). (5)Results of sociological evaluation: the reported incidence of pulmonary tuberculosis decreased from 78.04/100 000 in 2016 decrease to 53.76/100 000 in 2020. There were 5 697 cases of pulmonary tuberculosis managed by standardized method, with a standardized management rate of 95.76%; 6 015 cases of pulmonary tuberculosis were successfully treated, with a success rate of 95.31%. (6) Results of economic evaluation: a total of 768 lives were saved in disability adjusted life year (DALY) 63 392, and 60 150-90 225 healthy people were protected from tuberculosis infection. It reduced the number of new cases of infectious pulmonary tuberculosis by 3 008-4 512, avoided the loss of new cases by31702-47551,and recovered theloss ofgross domestic product(GDP)by961022.72Yuan. Conclusions The benefits of tuberculosis screening among key groups in Haizhu District of Guangzhou City have been achieved. The mode of active detection of key groups should be promoted, in order to reduce the spread of tuberculosis and accelerate the decline of tuberculosis epidemic.

Key words: Pulmonary tuberculosis, Key groups, Screening

摘要： 目的 分析2016年至2020年“十三五结核病防治规划”实施期间广州市海珠区重点人群结核病筛查情况，评估结核病防控成效，为制定结核病防控策略提供科学依据。方法 采用回顾性研究、社会学及经济学评价方法，对广州市海珠区 2016年1月至 2020年12月病原学阳性肺结核患者家庭成员、65 岁及以上老年人、糖尿病患者、学校肺结核密切接触者筛查进行分析。计数资料组间比较采用 χ2 检验。结果 （1）累计登记病原学阳性肺结核患者 2 911 例，进行家庭密切接触者筛查 8 714 例，筛查率 99.86%，检出率 0.24%（21/8 714），有临床症状者肺结核检出率高于无临床症状者。 （2）累计对65岁及以上老年人进行肺结核可疑症状筛查8 606例，筛查率1.26%（8 606/682 011）；对糖尿病患者进行肺结核可疑症状筛查10 472例，进行胸片筛查4 964例，发现肺结核患者211例，检出率 1.11%（211/19 078）。（3）累计对3 741例肺结核患者开展艾滋病病毒（HIV）筛查，HIV初筛阳性11例， 检出率0.29%（11/3 741）；累计对6 697例HIV感染患者开展肺结核筛查，发现肺结核患者55例，检出率 0.82%（55/6 697）。（4）累计登记学校肺结核患者 445 例，进行密切接触者筛查 14 304 例，筛查率 92.53%，发现肺结核患者13例，全部为病原学阴性学生患者，检出率0.09%（13/14 304）。（5）社会学评价结果。肺结核患者报告发病率从2016年78.04/10万逐年递降至2020年53.76/10万；累计规范管理 肺结核患者 5 697 例，规范管理率为 95.76%；累计成功治疗肺结核患者 6 015 例，成功治疗率为 95.31%。（6）经济学评价结果。累计挽回伤残调整生命年（DALY）63 392年，获得完整生命数 768个， 免受结核菌感染的健康人数60 150～90 225人；减少新发传染性肺结核病人数3 008～4 512人，避免 了新发病例损失31 702～47 551年，挽回国内生产总值（GDP）损失961 022.72元。结论 广州市海珠区重点人群结核病筛查取得较好的成效，应积极推行重点人群“主动发现”模式，减少结核病传播，加速结核病疫情下降。

关键词: 肺结核, 重点人群, 筛查