Preliminary Study On The Current Situation Of Prevention And Treatment For Hydatid Patients And The Model Of Combined Therapy And Prevention In Xinjiang Epidemic Areas

Objective: By investigating the drug treatment status of patients in the hydatid epidemic area in Xinjiang,this study explored the diagnosis and treatment of hydatid patients under the model of combined hydatid therapy and prevention and the path of overall health management,summarized the effect and existing problems of the current model,and put forward evaluation criteria,so as to provide scientific basis for the formulation of the implementation plan of the model of combined hydatid therapy and prevention and the initial evaluation of intervention.Methods: Data of hydatid patients registered in designated hospitals and CDC of Qitai,Jimusar and Chabuchaer from 2011 to 2017 were collected.The data of patients’ medical records and follow-up information were collated by the principle of double entry.The research methods of combining quantitative and qualitative methods were applied to base the patient control system in Xinjiang hydatid endemic areas.Baseline survey was conducted on the patient control system in Xinjiang hydatid epidemic areas;follow-up was conducted on the whole treatment process of hydatid patients in the first pilot counties,and comparative analysis was made on the treatment situation before and after the the model of combined hydatid therapy and prevention.Bagging model,AdaBoost model,Random Forest model and Logistic regression model were used to analyze the indicators that might affect the follow-up effect.Semi-structured questionnaire survey were used to analyze the implementation effect of the model of combined hydatid therapy and prevention.All the respondents signed the informed consent.Result: Hydatid patients were mainly distributed in rural areas(85.9%),most of them were in high school or below(96.3%)and 55.6%(75/135)were relapsed and treated again.34.8%(47/135)of the follow-up medication did not meet the standard.Analysis of influencing factors of effective follow-up medication in patients with hydatid showed that age,occurrence of adverse drug reactions and times of administration had great influence on the effective follow-up medication rate.After the implementation of the model of combined hydatid therapy and prevention,the proportion of unknown diagnosis stages of Cystic Echinococcosis in Jimusar decreased by 26.9%.The pilot counties have straightened out the linkage mechanism between hydatid hospitals and CDC.Based on the experience of the pilot counties and the problems found in the qualitative interviews,four stages and three perspectives are suggested for the promotion of the next stage of the pilot work of the model of combined hydatid therapy and prevention.The interview materials,expert opinions and working experience of the pilot counties are summarized and sorted out.Suggestions are made from the supplier and the demander for evaluation indicators,covering policies,funds,personnel and satisfaction.Conclusion: Hydatid patients had high recurrence rate in Xinjiang,and the effective follow-up medication rate is low.The pilot work has initially formed a linkage mechanism between medical institutions and CDC institutions,and the accuracy of patient diagnosis has been improved,but the working model still needs to be improved.The work model was optimized into four stages of patient consultation,diagnosis,treatment and follow-up,three perspectives of patients,medical institutions and CDC institutions,and evaluation indicators were put forward.This study provides a reference for extending the model of combined hydatid therapy and prevention to 45 designated hospitals in Xinjiang.