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Prevalencia de la tuberculosis en China, 1990-2010; un análisis longitudinal de los datos de las encuestas nacionales

Lixia Wang¹, Hui Zhang¹, Yunzhou Ruan¹

¹Chinese Center for Disease Control and Prevention, Beijing, China.

Lancet (London, England)

|March 22, 2014

Resumen

China China China China también.

Área de la Ciencia:

Salud Pública La salud pública.
Epidemiología La epidemiología.
Control y Control de Enfermedades Infecciosas

Sus antecedentes:

China implementó un programa nacional de control de la tuberculosis basado en el tratamiento directamente observado, la estrategia de corto curso (DOTS) a partir de la década de 1990.
La estrategia DOTS se expandió a nivel nacional después del año 2000, cubriendo a toda la población.
Este estudio evalúa el impacto epidemiológico del programa nacional de control de la tuberculosis de China.

Objetivo del estudio:

Evaluar la efectividad del programa nacional de control de la tuberculosis de China.
Analizar las tendencias en la prevalencia de la tuberculosis y los resultados del tratamiento durante dos décadas.
Determinar la contribución de la estrategia DOTS a la reducción de la carga de la tuberculosis.

Principales métodos:

Análisis longitudinal de tres encuestas nacionales de prevalencia de tuberculosis realizadas en 1990, 2000 y 2010.
Muestreo aleatorio estratificado de 252.940 individuos mayores de 15 años en la encuesta de 2010 en 31 provincias continentales.
Diagnóstico de la tuberculosis a través de radiografía de tórax, microscopía de esputo y cultivo, con entrevistas para los casos confirmados.

Principales resultados:

La prevalencia de la tuberculosis positiva al frotis disminuyó de 170 a 59 por cada 100.000 habitantes entre 1990 y 2010.
La disminución de la prevalencia se aceleró después de 2000, con una reducción del 57% en comparación con el 19% en la década de 1990.
El cambio en el tratamiento de los hospitales a los centros de salud pública utilizando DOTS aumentó del 15% en 2000 al 66% en 2010, reduciendo las tasas de retraso y retratamiento del tratamiento.

Conclusiones:

China logró reducir a la mitad su prevalencia de tuberculosis en 20 años.
La mejora del tratamiento de la tuberculosis, impulsada por la estrategia DOTS implementada en los centros de salud pública, fue un factor clave.
El estudio destaca el impacto significativo en la salud pública de un programa de control de la tuberculosis a gran escala y basado en estrategias.

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