Development and Application of a Multidrug-Resistant Tuberculosis Case Management System—Yunnan Province,China,2017–2020

作     者：Jinou Chen Yunzhou Ruan Kai Wang Ling Li Yunbin Yang Rui Yang Lin Xu 

作者机构：Yunnan Center for Disease Control and PreventionKunming CityYunnan ProvinceChina National Center for Tuberculosis Control and PreventionChina CDCBeijingChina Family Health International 360 China Kunming OfficeKunming CityYunnan ProvinceChina 

出 版 物：《China CDC weekly》 (中国疾病预防控制中心周报（英文）)

年 卷 期：2022年第4卷第38期

页      面：855-861页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：Funded by the Yunnan Health Training Program for High-Level Talents(Grant No.H-2019027)and Yunnan Provincial High-Level Talent Incubator Program. 

主　　题：pilot strengthened Management 

摘      要：Introduction:Treatment and case management of multidrug-resistant tuberculosis(MDR-TB)is a significant challenge in tuberculosis(TB)control and prevention.This pilot study aims to apply and test a new electronic information system in order to help bolster case management of MDR-TB.Methods:The MDR-TB Case Management System(CMS)was developed and piloted in the Yunnan Tuberculosis Clinical Center(TCC)in 2017.Next,5 sites in Yunnan were randomly selected and sampled as pilots in 2018.The real-time regular follow-up rate(RFUR)was calculated for pilot sites.Loss to follow-up(LTFU)rates of MDR-TB treatment cohorts between pilot and non-pilot sites were compared by a chi-square test.LTFU for MDR-TB treatment cohorts was then assessed by univariate and multivariate binary logistic regression.Results:The average regular follow-up rate was 90.7%in TCC and 73.7%in five other pilot sites of Yunnan Province respectively.The average LTFU rate for pilot sites(9.0%)was lower than non-pilot sites(20.6%,P0.01).The risk of LTFU during MDR-TB treatment reduced 61.7%in CMS pilot cases(adjusted odds ratio:0.38,95%confidence interval:0.23–0.60)compared with non-pilot cases.Conclusions:As a significant supplement to the Tuberculosis Information Management System,the CMS strengthened the collection,analysis,and utilization of strategic information for MDR-TB cases.The system improved case management by embedding it as a tool of the Comprehensive Supportive Care service model.