結核管理の進化と,世界的に結核の発生率,流行率,死亡率を減らす見通し
Christopher Dye1, Catherine J Watt, Daniel M Bleed
1Stop TB Department, World Health Organization, Geneva, Switzerland. dyec@who.int
JAMA
|June 9, 2005
まとめ
結核 (TB) 制御プログラムが進展しており,世界的に症例発見と治療の成功率が上昇しています. しかし,2015年までにミレニアム開発目標を達成するには,特にアフリカと東ヨーロッパで,より一層の努力が必要です.
科学分野:
- 公衆衛生は公衆衛生である.
- 感染症疫学 感染症疫学
- グローバル・ヘルス・ポリシー
背景:
- 国連のミレニアム開発目標 (MDGs) は,DOTS.のような結核対策戦略の評価を推進しています.
- DOTSやその他の結核対策の影響を評価することは,世界保健目標の達成に不可欠です.
研究 の 目的:
- 2015年までに結核対策に関するMDGの目標を達成する可能性を評価する.
- 主な目標は,新しいスプレー陽性の症例の70%を検出し,85%を治療し,TBの発生率,罹患率,死亡率を削減することです.
主な方法:
- 結核症例報告,コホート治療結果,死亡記録,および最大200カ国の流行調査 (1980-2003) を利用した.
- データは,DOTSおよび非DOTSプログラムを含むWHOのグローバルTBデータベースから得られたものです.
- 2015年までの9つの異なるグローバル地域における推定TB発生率,罹患率,死亡率.
主要な成果:
- 2003年,世界の結核の発生率は上昇したが,HIVに感染したアフリカの一部を除く9地域のうち7地域では安定または減少した.
- DOTSの症例検出は大幅に改善され,2003年には45%に達し,2005年までに60%に達すると予測されています.
- 治療の全体的な成功率は1998年以来80%を超えましたが,地域差は依然としてあり,最も低い割合はアフリカと東ヨーロッパにあります.
結論:
- 2015年までにTB削減のためのMDGの目標を達成することは,ほとんどの地域では可能である.
- アフリカと東欧では依然として重大な課題が残っており,結核対策の強化が求められている.
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